Individual provider Active NPI

Dylan Tyler Way

  • Peer Specialist
  • Oklahoma City, OK
National Provider Identifier
1972044816
Registry record updated Mar 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
2625 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone
(757) 355-1942
NPI assigned
Mar 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

2625 General Pershing Blvd
Oklahoma City, OK 73107-6437

Mailing address

20441 SE 8TH St
Harrah, OK 73045-6477
Phone (757) 355-1942

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

NPI Registry JSON

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

{
    "created_epoch": "1489190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489190400000",
    "number": "1972044816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20441 SE 8TH ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730456477",
            "telephone_number": "757-355-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 GENERAL PERSHING BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076437",
            "telephone_number": "757-355-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAY",
        "first_name": "DYLAN",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-11",
        "last_updated": "2017-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2017; 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.