MR. ROBERT SAMUEL TYSON (NPI# 1063743425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063743425 |
| Entity Type | Individual |
| Full Name | MR. ROBERT SAMUEL TYSON |
| Credential | PA-C |
| Practice Address |
2501 W 22nd St Sioux Falls SD 57105-1305 |
| Practice Telephone | 6053363230 |
| Practice Fax Number | 6953335311 |
| Mailing Telephone | 6053363230 |
| Mailing Fax Number | 6953335311 |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2010-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922267863 | Robert Neville Tyson | Internal Medicine | 24217 139th Ave Se, Kent, WA 98042-5166 | 2008-06-05 |
| 1336336759 | Robert John Tyson IIi | Licensed Practical Nurse | 215 Standish Dr, Syracuse, NY 13224-1913 | 2007-09-30 |
| 1023219607 | Robert Harry Tyson | Pediatrics | 121 Mahogany Bay Dr, Saint Johns, FL 32259-6949 | 2007-05-30 |
| 1639203045 | Robert L Tyson | Psychiatry & Neurology | 1687 114th Ave Se, Suite 125, Bellevue, WA 98004-6964 | 2007-03-15 |
| 1851405252 | Robert Lindsey Tyson | Pharmacist | 215 W Pecan St, Coleman, TX 76834-4147 | 2006-08-19 |
| 1629047477 | Robert Weslie Tyson | Pathology | 6750 W 52nd Ave, Suite F, Arvada, CO 80002-3956 | 2006-03-15 |
| Street Address |
2501 W 22ND ST |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306840111 | Douglas D. Tassi | Optometrist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2005-06-09 |
| 1710598941 | Courtney Beth Younge | Pharmacist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2020-08-12 |
| 1780292243 | Matthew Scott Wiemann | Pharmacist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2020-07-21 |
| 1578195038 | Darcy Amanda Lowman-craig | Social Worker | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2020-02-12 |
| 1871137083 | Brandon David Hubert | Pharmacist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-10-30 |
| 1366083529 | Janis Rae Lindstrom | Technician | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-09-30 |
| 1528629045 | Khia Ann Warzecha | Pharmacist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-06-25 |
| 1053978445 | Stephani Ann Kringstad | Registered Nurse | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-05-21 |
| 1043874399 | Susan Morgan | Social Worker | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-04-23 |
| 1306306519 | Melissa Jane Suter | Social Worker | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627898 | Mikaela Theobald | Physician Assistant | 6101 E Quartzite Dr, Sioux Falls, SD 57110-3988 | 2020-10-22 |
| 1467064097 | Kara Rae Koth | Physician Assistant | 4913 E 42nd St, Sioux Falls, SD 57110-4409 | 2020-08-17 |
| 1528695798 | Allison Mcentee | Physician Assistant | 3620 East Prairiewind Street, Sioux Falls, SD 57108 | 2020-03-26 |
| 1326608910 | Ashley Pommer | Physician Assistant | 8232 W 51st St, Sioux Falls, SD 57106-7861 | 2019-06-17 |
| 1225550908 | Almir Krdzalic | Physician Assistant | 110 W Honors St, Sioux Falls, SD 57108-8174 | 2017-07-13 |
| 1598160335 | Heidi Jo Vogel | Physician Assistant | 1417 S Cliff Avenue, Suite 200, Sioux Falls, SD 57105 | 2014-10-22 |
| 1639507882 | Kelsey Isaacson | Physician Assistant | 4201 S Minnesota Ave, Suite 112, Sioux Falls, SD 57105-6705 | 2013-10-25 |
| 1033551114 | Karissa G Zimmer | Physician Assistant | 2315 W. 57th Street, Suite 300, Sioux Falls, SD 57108 | 2013-07-18 |
| 1740623065 | Nicolette Schmuck | Physician Assistant | 1500 W 22nd St Ste 302, Sioux Falls, SD 57105-1599 | 2013-04-17 |
| 1023389392 | Leah Ayn Mergen | Physician Assistant | 521 N Main Ave Ste 100, Sioux Falls, SD 57104-5947 | 2012-01-19 |
| Find all providers in SIOUX FALLS | ||||
| City | SIOUX FALLS |
| Zip Code | 57105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.