Derek James Tully

Primary specialty

PharmacistTaxonomy code 183500000X

License

7685428-1701 Issued in UT

Practice address

2332 E 2100 S
Salt Lake City, UT 84109-1319

Phone

(801) 466-9949

Fax

(801) 467-6742

NPI assigned

Aug 12, 2020

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1972114007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8649 N PINE VALLEY ALY",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055261",
            "telephone_number": "256-654-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091319",
            "telephone_number": "801-466-9949",
            "fax_number": "801-467-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "DEREK",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "7685428-1701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH DEPARTMENT OF PROFESSIONAL LICENSING",
            "identifier": "7685428-8911",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH DEPARTMENT OF PROFESSIONAL LICENSING",
            "identifier": "7685428-1701",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Felicia Tulak
• Alexandra Marie Tulin
• Benton Tullis
• Travis Tullis, AUD
• Janet E Tulloch, R.N., M.S.N., C.N.P.
• Shilpa S. Tummala, MD
• Rosalin Tunbridge
• Jivatesh Singh Tung, MD
• Kristan Tunks, RN
• Kristen Tuntland, CSW

• Pharmacist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pharmacist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.