Tyler Ryan Clements, CSFA, CST

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

174816 Issued in CO

Practice address

1024 Central Park Dr
Steamboat Springs, CO 80487-8813

Phone

(970) 819-0282

NPI assigned

Jun 12, 2017

Last updated

Sep 28, 2017By the provider in NPPES

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

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": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1003346164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LINCOLN AVE #771057",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "80477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 CENTRAL PARK DR",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804878813",
            "telephone_number": "970-819-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "TYLER",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "CSFA, CST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "174816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Steamboat Springs (Steamboat Springs Fire Rescue)
• City of Steamboat Springs (Steamboat Springs Ambulance)
• Phyllis Susan Clark, MSW
• Classic Air Care LLC (Classic Lifeguard)
• Emily Cleary, DPM
• Jennifer Margaret Cohen, PA
• Nancy Cohen, R.D.
• Jeannine Colloton
• Colorado Dental, PC (Dental Center of Steamboat)
• Colorado Laser Dentistry, PC (Sleeping Giant Sleep Solutions)

• Surgical Physician Assistant in Steamboat Springs, CO
• Providers in Steamboat Springs, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.