Individual provider Active NPI

William Tyler Halstead, PHARMD

  • Pharmacist
  • Gate City, VA
National Provider Identifier
1912336397
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202212289 Issued in VA
Practice address
119 E Jackson St
Gate City, VA 24251-3418
Phone
(276) 863-8213
Fax
(276) 386-7582
NPI assigned
Nov 5, 2013
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202212289VAMDPharmacist
23962NCMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past
since Dec 28, 2022
Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 23962 NC
Pharmacist 183500000X 0202212289 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

119 E Jackson St
Gate City, VA 24251-3418

Mailing address

119 E Jackson St
Gate City, VA 24251-3418
Phone (276) 386-3821

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 19, 2022.

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1912336397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E JACKSON ST",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "242513418",
            "telephone_number": "276-386-3821",
            "fax_number": "276-386-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E JACKSON ST",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "242513418",
            "telephone_number": "276-863-8213",
            "fax_number": "276-386-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "WILLIAM",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-05",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "23962",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202212289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gate City, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.