TIYA SHALYSE JOHNSON M.D. NPI 1154696359

NPI Information

  • NPI: 1154696359
  • Provider Name: TIYA SHALYSE JOHNSON, M.D.
  • Classification: Psychiatry & Neurology - 2084P0804X
  • Specialization: Child & Adolescent Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11937 US HIGHWAY 271
    TYLER, TX
    ZIP 75708
  • Phone: (903) 877-7168

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NPI Details

Tiya Shalyse Johnson, M.D. is a child and adolescent psychiatry psychiatry neurology in Tyler, TX. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Tiya Shalyse Johnson, M.D. NPI is 1154696359. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11937 US HIGHWAY 271
TYLER, TX
ZIP 75708-154
Phone: (903) 877-7168
Fax: (903) 877-8355

The NPI 1154696359 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2012 and was last updated on 8/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084F0202XPsychiatry & NeurologyForensic Psychiatry48143KENTUCKYNo
22084F0202XPsychiatry & NeurologyForensic Psychiatry130324OHIONo
32084F0202XPsychiatry & NeurologyForensic PsychiatryME129560FLORIDANo
42084P0800XPsychiatry & NeurologyPsychiatry130324OHIONo
52084P0800XPsychiatry & NeurologyPsychiatryME129560FLORIDANo
62084P0800XPsychiatry & NeurologyPsychiatry48143KENTUCKYNo
72084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryS7462TEXASYes
82084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry48143KENTUCKYNo
92084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryME129560FLORIDANo
102084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry130324OHIONo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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