Individual provider Active NPI

Tyler Dewitt Cobb, DPT

  • Physical Therapist
  • Raleigh, NC
National Provider Identifier
1053080853
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20717 Issued in NC
Practice address
11081 Forest Pines Dr Ste 112
Raleigh, NC 27614-7656
Phone
(919) 562-9410
NPI assigned
Sep 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P20717 NC Primary

Addresses

Primary practice location

11081 Forest Pines Dr Ste 112
Raleigh, NC 27614-7656

Mailing address

11081 Forest Pines Dr Ste 112
Raleigh, NC 27614-7656
Phone (919) 562-9410

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tyler.cobb.1@12529.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211102001956 NC Practitioner - Physical Therapist in Private Practice 4082002522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians

Practice addresses (Care Compare)

11081 Forest Pines Dr
Suite 112
Raleigh, NC 27614-7656
Phone (919) 562-9410

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
61.01
Promoting interoperability
100
Improvement activities
40
Cost
82.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of North Carolina, P.a. Physical Therapist CurrentSince Aug 29, 2021 Accepting new patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Aug 29, 2021 Accepting new patients

Locations

6602 Knightdale Blvd
Ste 310
Knightdale, NC 27545

11081 Forest Pines Dr
Ste 112
Raleigh, NC 27614
Phone (252) 478-3736

11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1053080853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11081 FOREST PINES DR STE 112",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147656",
            "telephone_number": "919-562-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11081 FOREST PINES DR STE 112",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147656",
            "telephone_number": "919-562-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "TYLER",
        "middle_name": "DEWITT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.cobb.1@12529.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "11081 Forest Pines Dr Ste 112",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276147656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.