Individual provider Active NPI

Tysherra Brooks

  • Phlebotomy Technician
  • Cheltenham, PA
National Provider Identifier
1750041877
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
84755-184670081811 Issued in PA
Practice address
545 Ashmead Rd
Cheltenham, PA 19012-1504
Phone
(267) 401-7036
NPI assigned
Dec 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 246RP1900X 84755-184670081811 PA Primary

Addresses

Primary practice location

545 Ashmead Rd
Cheltenham, PA 19012-1504

Mailing address

545 Ashmead Rd
Cheltenham, PA 19012-1504
Phone (267) 401-7036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
84755-184670081811PAMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
At Your Side Mobile Phlebotomy LLC Single Specialty CurrentSince Jan 2, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1750041877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 ASHMEAD RD",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121504",
            "telephone_number": "267-401-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 ASHMEAD RD",
            "city": "CHELTENHAM",
            "state": "PA",
            "postal_code": "190121504",
            "telephone_number": "267-401-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "TYSHERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "PA",
            "license": "84755-184670081811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheltenham, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.