Individual provider Active NPI

Tyra Dean-Ousley, EDD, APN, FNP-BC

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1073049722
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277002442 Issued in IL
Practice address
235 E Princeton St Ste 200
Orlando, FL 32804-5555
Phone
(407) 303-1444
Fax
(407) 303-1446
NPI assigned
May 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11023314 FL
Family Nurse Practitioner 363LF0000X 209015881 IL
Family Nurse Practitioner 363LF0000X 277002442 IL Primary

Addresses

Primary practice location

235 E Princeton St Ste 200
Orlando, FL 32804-5555

Mailing address

11228 S Emerald Ave
Chicago, IL 60628-4707
Phone (773) 425-9946

Other practice location 1

11228 S Emerald Ave
Chicago, IL 60628-4707
Phone (773) 821-7155

Other practice location 2

1276 N Clybourn Ave
Chicago, IL 60610-2003
Phone (312) 337-1073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231021000396 IL Practitioner - Nurse Practitioner 8123485414 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11023314FLMDFamily Nurse Practitioner
209015881ILMDFamily Nurse Practitioner
277002442ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Behavior Health Services Current Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Oct 12, 2023 Accepting new patients
Millennium Behavior Health Services Family Current Accepting new patients
Fitness Clinic Wellness Family CurrentSince Apr 3, 2024 Accepting new patients
Cook County CurrentSince Oct 12, 2023 Accepting new patients
Saint Francis Medical Center Past Accepting new patients
Chicago State University PastSince Apr 23, 2023 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

20303 Crawford Ave
Ste 230
Olympia Flds, IL 60461
Phone (708) 679-1000

Organizations & group practices 8

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1073049722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11228 S EMERALD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284707",
            "telephone_number": "773-425-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E PRINCETON ST STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045555",
            "telephone_number": "407-303-1444",
            "fax_number": "407-303-1446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11228 S Emerald Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606284707",
            "country_code": "US",
            "telephone_number": "773-821-7155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1276 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606102003",
            "country_code": "US",
            "telephone_number": "312-337-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN-OUSLEY",
        "first_name": "TYRA",
        "credential": "EDD, APN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023314",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015881",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277002442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.