Avery Tomberlin

Primary specialty

PharmacistTaxonomy code 183500000X

License

54472 Issued in TX

Practice address

9625 White Settlement Rd
Fort Worth, TX 76108-4406

Phone

(817) 367-3469

NPI assigned

Jun 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rxm.07898@store.walgreens.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1891177820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 WHITE SETTLEMENT RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084406",
            "telephone_number": "817-367-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 WHITE SETTLEMENT RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084406",
            "telephone_number": "817-367-3469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 Main St",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "786103393",
            "country_code": "US",
            "telephone_number": "817-295-2564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMBERLIN",
        "first_name": "AVERY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "54472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891177820",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rxm.07898@store.Walgreens.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DPI",
            "address_1": "9625 White Settlement Rd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761084406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cindi E Tolliver, RPH
• Lacedric Reitrich Tolliver, D.M.D.
• Tom Annunziato, OD PC
• Tom J. Shirey, O.D., P.a.
• Venus Tombakoglu
• Benjamin Tomelleri-Galichia, MD
• Tomi'S Caring Hands Senior Services
• Dawndi Shantelle Tomlinson, D.C.
• Heidi Danielle Tomlinson, M.D.
• Odette Tomlinson, LPC-S

• Pharmacist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.