Tyler Russell Purvis, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Perry, Georgia. His current practice location is
110 Kellwood Dr Ste 220a, Perry, Georgia. You can reach out to his office (for appointments etc.) via phone at
(478) 300-7020.
Tyler Russell Purvis is licensed to practice in Georgia (license number 92587) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164996104.
Physician's Profile
Full Name | Tyler Russell Purvis |
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Gender | Male |
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Speciality | Psychiatry & Neurology - Psychiatry |
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Location | 110 Kellwood Dr Ste 220a, Perry, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164996104
- Provider Enumeration Date: 01/13/2019
- Last Update Date: 11/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 5991035628
- Enrollment ID: I20230912003084
Medical Identifiers
Medical identifiers for Tyler Russell Purvis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164996104 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | 92587 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tyler Russell Purvis allows following entities to bill medicare on his behalf.
Entity Name | Resilient Minds Psychiatric Care Of Middle Georgia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1871272765 PECOS PAC ID: 7012379423 Enrollment ID: O20230817000773 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyler Russell Purvis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tyler Russell Purvis, MD 110 Kellwood Dr Ste 220a, Perry, GA 31069-3263 Ph: (478) 300-7020 | Tyler Russell Purvis, MD 110 Kellwood Dr Ste 220a, Perry, GA 31069-3263 Ph: (478) 300-7020 |
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