Jeanette Courtney Tyler, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

017389 Issued in NY

Practice address

2236 Connell Ter
Baldwinsville, NY 13027-1031

Phone

(585) 802-2091

NPI assigned

Jun 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1104669837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 CONNELL TER",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271031",
            "telephone_number": "585-802-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 CONNELL TER",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130271031",
            "telephone_number": "585-802-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "JEANETTE",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark L Tripepi, PHARMD
• Suzanne Elizabeth Trombley
• Meredith Truley
• Pamela Maree Tucker, PT, DPT
• Meghan M Turley, DPT
• Sarah Jane Tyner, MSN, RN, NNP
• Audrey Irene Tyszka, LCSW-R
• University Hospital
• Upstate Chiropractic, PC
• Upstate Psychiatric Care

• Occupational Therapist in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.