Active NPI
Tyler John Gale, FNP-BC
- Family Nurse Practitioner
- Montgomery, AL
National Provider Identifier
1790279685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP11410
- Practice address
- 300 Twining St # 760
Montgomery, AL 36112-6027 - Phone
- (334) 953-3368
- NPI assigned
- Jun 14, 2018
- Last updated
- Jul 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP11410 | AZ | Primary |
Addresses
Primary practice location
300 Twining St # 760
Montgomery, AL 36112-6027
Mailing address
9733 E Theia Dr
Mesa, AZ 85212-8524
Phone (602) 350-1853
Other practice location 1
9733 E. Theia Dr.
Gilbert, AZ 85234
Phone (602) 350-1853
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181112001293 | AZ | Practitioner - Nurse Practitioner | 1355695214 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP11410 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtualmed PLLC | Family | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Virtual Med
- Psychiatric/Mental Health Nurse Practitioner
- Mesa, AZ
- NPI 1104609932
Family
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1790279685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9733 E THEIA DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852128524",
"telephone_number": "602-350-1853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 TWINING ST # 760",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361126027",
"telephone_number": "334-953-3368"
}
],
"practiceLocations": [
{
"address_1": "9733 E. Theia Dr.",
"address_purpose": "LOCATION",
"city": "GILBERT",
"state": "AZ",
"postal_code": "85234",
"country_code": "US",
"telephone_number": "602-350-1853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GALE",
"first_name": "TYLER",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-14",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP11410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.