Individual provider Active NPI

Cornelius Regina Tyler, FNP

  • Family Nurse Practitioner
  • Fort Eisenhower, GA
National Provider Identifier
1851367114
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN320315 Issued in GA
Practice address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone
(706) 787-5811
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN320315 GA Primary
Family Nurse Practitioner 363LF0000X 4304P KY

Addresses

Primary practice location

300 W Hospital Rd
Fort Eisenhower, GA 30905-5741

Mailing address

3507 Monroe CT
Augusta, GA 30909-9243
Phone (270) 339-1183

Other practice location 1

Blanchfield Army community Hospital
650 Joel Dr.
Fort Campbell, KY 42223-5349
Phone (270) 798-8372

Other practice location 2

4210 Columbia Rd Ste 14B
Martinez, GA 30907-0446
Phone (706) 854-9807

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
RN320315GAMDFamily Nurse Practitioner
4304PKYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1851367114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 MONROE CT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309099243",
            "telephone_number": "270-339-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Blanchfield Army community Hospital",
            "address_2": "650 Joel Dr.",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235349",
            "country_code": "US",
            "telephone_number": "270-798-8372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4210 Columbia Rd Ste 14B",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "GA",
            "postal_code": "309070446",
            "country_code": "US",
            "telephone_number": "706-854-9807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "CORNELIUS",
        "middle_name": "REGINA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN320315",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4304P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eisenhower, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; 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.