Kelley Rose Myrita Tyndall

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7932 Summa Ave Ste B2
Baton Rouge, LA 70809-3736

Phone

(225) 349-7171

NPI assigned

Apr 25, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1720834286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 ROYAL MARCO WAY",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341451829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 SUMMA AVE STE B2",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093736",
            "telephone_number": "225-349-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALL",
        "first_name": "KELLEY ROSE",
        "middle_name": "MYRITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kate Harb Tyl, PA-C
• Alisyn Noel Tyler
• April Michelle Tyler, CMA, CNA
• Jennifer Tyler
• Robyn Easton Tyler, MD
• McKenzie Leblanc Tyson, PT, DPT, OCS
• Patrice Jenne Tyson, MD
• Porsche Ceairo Ivory Uche, NP
• Aniedi Etukudo Fred Udofa, M.D.
• Andikan Effiong Udoh, M.D.

• Behavior Technician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Behavior Technician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.