Individual provider Active NPI

Tyler John Gale, FNP-BC

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1790279685
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11410 Issued in AZ
Practice address
300 Twining St # 760
Montgomery, AL 36112-6027
Phone
(334) 953-3368
NPI assigned
Jun 14, 2018
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181112001293 AZ Practitioner - Nurse Practitioner 1355695214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP11410AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtualmed PLLC Family CurrentSince Mar 12, 2024 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.

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

Verify at the official NPI Registry.