The Wellness Station 2, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THE WELLNESS STATION 2, LLC

Practice address

3500 Westgate Dr Ste 504
Durham, NC 27707-2568

Phone

(919) 489-8809

NPI assigned

Nov 21, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jacob Tyson, DPTNPI 1922600543

Title

Owner

Phone

(919) 951-8457

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Clifford Tyson, DPT

  • Physical Therapist
  • Durham, NC
  • NPI 1922600543
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1013878719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N FORK RD",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287112513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 WESTGATE DR STE 504",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072568",
            "telephone_number": "919-489-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS STATION 2, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-21",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-951-8457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brent Jason Theiling
• Megan McGuiness Theiling, S.L.P.
• Maryanne Thelusma

• Physical Therapy Clinic/Center in Durham, NC
• Providers in Durham, NC by specialty
• Physical Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.