Individual provider Active NPI

Janice Tysoe, PHARMACIST

  • Pharmacist
  • Safford, AZ
National Provider Identifier
1770905135
Registry record updated Jan 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S006529 Issued in AZ
Practice address
755 S 20TH Ave
Safford, AZ 85546-3322
Phone
(928) 428-0238
Fax
(928) 428-0238
NPI assigned
Jan 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S006529 AZ Primary
Pharmacist 183500000X 31213 CA

Addresses

Primary practice location

755 S 20TH Ave
Safford, AZ 85546-3322

Mailing address

909 W Relation St
Safford, AZ 85546-3203
Phone (928) 428-0238

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
31213CAMDChiropractor
S006529AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1390089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390089600000",
    "number": "1770905135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W RELATION ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463203",
            "telephone_number": "928-428-0238",
            "fax_number": "928-428-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463322",
            "telephone_number": "928-428-0238",
            "fax_number": "928-428-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSOE",
        "first_name": "JANICE",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-19",
        "last_updated": "2014-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S006529",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "31213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2014; 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.