Active NPI
Roy Nando Tyler, CSA
- Surgical Physician Assistant
- Bowling Green, KY
National Provider Identifier
1952337560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- SA066
- Practice address
- 1945 Scottsville Rd
B2 PMB 137
Bowling Green, KY 42104-3376 - Phone
- (270) 782-0434
- NPI assigned
- Jun 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | SA066 | KY | Primary |
Addresses
Primary practice location
1945 Scottsville Rd
B2 PMB 137
Bowling Green, KY 42104-3376
Mailing address
1945 Scottsville Rd
B2 PMB 137
Bowling Green, KY 42104-3376
Phone (270) 782-0434
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000212655 | Other | KY | ANTHEM |
| 58221859-C | Other | KY | HUMANA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA066 | KY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1952337560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1945 SCOTTSVILLE RD",
"address_2": "B2 PMB 137",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421043376",
"telephone_number": "270-782-0434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1945 SCOTTSVILLE RD",
"address_2": "B2 PMB 137",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421043376",
"telephone_number": "270-782-0434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "ROY",
"middle_name": "NANDO",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "KY",
"license": "SA066",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000212655",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "58221859-C",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.