Matthew Tyler Johnson, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

26025460A Issued in IN

Practice address

1366 N Gardner St
Scottsburg, IN 47170-7793

Phone

(812) 752-4226

Fax

(812) 752-4056

NPI assigned

Oct 9, 2015

Last updated

Jan 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1891166351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 N GARDNER ST",
            "address_2": "P.O. BOX 346",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707793",
            "telephone_number": "812-752-4226",
            "fax_number": "812-752-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 N GARDNER ST",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471707793",
            "telephone_number": "812-752-4226",
            "fax_number": "812-752-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "TYLER",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26025460A",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "016971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Scottsburg, IN
• Providers in Scottsburg, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.