Individual provider Active NPI

Tyler Mullins, PHARM.D.

  • Pharmacist
  • Pikeville, KY
National Provider Identifier
1750826640
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
018095 Issued in KY
Practice address
2138 S Mayo TRL
Pikeville, KY 41501-2296
Phone
(606) 432-2044
Fax
(606) 432-4587
NPI assigned
Dec 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 018095 KY Primary
Pharmacist 183500000X 0202214010 VA

Addresses

Primary practice location

2138 S Mayo TRL
Pikeville, KY 41501-2296

Mailing address

PO Box 212
Clinchco, VA 24226-0212
Phone (276) 275-9079

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
018095KYMDPharmacist
0202214010VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K VA T Food Stores Inc Past Accepting new patients
K VA T Food Stores Inc Past Accepting new patients

Organizations & group practices 2

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": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1750826640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212",
            "city": "CLINCHCO",
            "state": "VA",
            "postal_code": "242260212",
            "telephone_number": "276-275-9079",
            "fax_number": "606-432-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 S MAYO TRL",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415012296",
            "telephone_number": "606-432-2044",
            "fax_number": "606-432-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "TYLER",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-30",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "018095",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202214010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.