Tyler Smith

Primary specialty

SpecialistTaxonomy code 174400000X

License

OT2992 Issued in MS

Practice address

1201 Highway 49 S
Suite 2
Richland, MS 39218-9425

Phone

(769) 233-8844

Fax

(769) 251-1825

NPI assigned

Feb 4, 2015

Last updated

Sep 21, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1942690490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 49 S",
            "address_2": "SUITE 2",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189425",
            "telephone_number": "769-233-8844",
            "fax_number": "769-251-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 49 S",
            "address_2": "SUITE 2",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392189425",
            "telephone_number": "769-233-8844",
            "fax_number": "769-251-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "OT2992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Richland, MS
• Providers in Richland, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.