Individual provider Active NPI

Tyler Ladner

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1093100752
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008124 Issued in VA
Practice address
1222 Jefferson Park Ave
Charlottesville, VA 22903-3410
Phone
(434) 982-3040
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110008124 VA Primary

Addresses

Primary practice location

1222 Jefferson Park Ave
Charlottesville, VA 22903-3410

Mailing address

PO Box 749112
Atlanta, GA 30374-9112
Phone (434) 295-1000

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 982-3040

Other practice location 2

260 Pantops Ctr
Charlottesville, VA 22911-8601
Phone (434) 244-3027

Other practice location 3

308 Corporate Dr
Ridgeland, MS 39157-8803
Phone (601) 898-7527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20211013000564 VA Practitioner - Physician Assistant 5991024739 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mississippi Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians
Bon Secours Urgent Care LLCGroup PAC ID 6709256142, 125 clinicians

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-0816

1222 Jefferson Park Ave
FL 3
Charlottesville, VA 22903-3410
Phone (434) 924-1931

260 Pantops Ctr
Charlottesville, VA 22911-8601
Phone (434) 244-3027

9851 Brook Rd
Glen Allen, VA 23059-4559
Phone (804) 893-8702

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110008124VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Virginia Urgent Care CurrentSince Oct 7, 2021 Accepting new patients
Medexpress Urgent Care, PC - Virginia Urgent Care CurrentSince Oct 7, 2021 Accepting new patients
First Intermed Corporation CurrentSince Apr 1, 2015 Accepting new patients
University of Virginia Physicians Group CurrentSince Jul 28, 2025 Accepting new patients

Locations

5606 Old Canton Rd
Jackson, MS 39211
Phone (601) 924-3350

342 Gilchrist Dr
Pearl, MS 39208
Phone (601) 939-0700

260 Pantops Ctr
Charlottesville, VA 22911
Phone (434) 244-3027

1222 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-1774

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Interoperability endpoints

  • Direct secure messaging: tladner684764@direct.healthsystem.virginia.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1093100752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 JEFFERSON PARK AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033410",
            "telephone_number": "434-982-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-982-3040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "260 Pantops Ctr",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229118601",
            "country_code": "US",
            "telephone_number": "434-244-3027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 Corporate Dr",
            "address_purpose": "LOCATION",
            "city": "Ridgeland",
            "state": "MS",
            "postal_code": "391578803",
            "country_code": "US",
            "telephone_number": "601-898-7527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LADNER",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.