Active NPI
Catherine Elaine Tyson, PHARM D
- Pharmacist
- Villa Rica, GA
National Provider Identifier
1972876449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 025938
- Practice address
- 601 Dallas Road
Villa Rica, GA 30180 - Phone
- (770) 456-3152
- Fax
- (770) 456-3200
- NPI assigned
- Feb 14, 2012
- Last updated
- Mar 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 025938 | GA | Primary |
Addresses
Primary practice location
601 Dallas Road
Villa Rica, GA 30180
Mailing address
601 Dallas Road
Villa Rica, GA 30180
Phone (770) 456-3152
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025938 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458864000000",
"number": "1972876449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 DALLAS ROAD",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "30180",
"telephone_number": "770-456-3152",
"fax_number": "770-456-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 DALLAS ROAD",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "30180",
"telephone_number": "770-456-3152",
"fax_number": "770-456-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYSON",
"first_name": "CATHERINE",
"middle_name": "ELAINE",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-14",
"last_updated": "2016-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "025938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Rica, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.