Tyler Jeffrey Noall, DC
Individual provider Active NPI Chiropractor · Hyde Park, UT
NPI 1003640756 · NPPES record last updated Jan 10, 2025
Key facts
- NPI
- 1003640756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 14152106-1202 (UT)
- Practice address
- 245 N 700 W
Hyde Park, UT 84318-4076 - Phone
- (435) 563-4141
- NPI assigned
- Aug 27, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240904000021 | UT | Practitioner - Chiropractic | 5890234983 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Red Tyde | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 14152106-1202 | UT | Yes |
Addresses
Primary practice location
245 N 700 W
Hyde Park, UT 84318-4076
Mailing address
245 N 700 W
Hyde Park, UT 84318-4076
Phone (435) 563-4141
Other providers in Hyde Park, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.