Individual provider Active NPI

Tyler Doran Ballinghoff, PHARMD

  • Pharmacist
  • Moorestown, NJ
National Provider Identifier
1962978627
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03965400 Issued in NJ
Practice address
228 Strawbridge Dr
Moorestown, NJ 08057-4600
Phone
(609) 257-8204
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03965400 NJ Primary

Addresses

Primary practice location

228 Strawbridge Dr
Moorestown, NJ 08057-4600

Mailing address

108 Winchester Way
Shamong, NJ 08088-9398
Phone (609) 257-8204

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03965400NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1962978627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WINCHESTER WAY",
            "city": "SHAMONG",
            "state": "NJ",
            "postal_code": "080889398",
            "telephone_number": "609-257-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 STRAWBRIDGE DR",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574600",
            "telephone_number": "609-257-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLINGHOFF",
        "first_name": "TYLER",
        "middle_name": "DORAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03965400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.