Individual provider Active NPI

Philip Tyler Tarrant, DPT

  • Physical Therapist
  • Lexington, SC
National Provider Identifier
1114574670
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42558 Issued in FL
Practice address
1787 S Lake Dr Ste H
Lexington, SC 29073-6736
Phone
(803) 957-0404
NPI assigned
Aug 20, 2019
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT03215 RI
Physical Therapist 225100000X 10960 SC
Physical Therapist 225100000X PT42558 FL Primary

Addresses

Primary practice location

1787 S Lake Dr Ste H
Lexington, SC 29073-6736

Mailing address

141 Atrium Way
Columbia, SC 29223-6301
Phone (803) 957-0404

Other practice location 1

2191 Post Rd
Warwick, RI 02886-1532
Phone (401) 681-4885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118000003 SC Practitioner - Physical Therapist in Private Practice 7416286398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10960SCMDPharmacist
PT42558FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy and Sports Medicine Limited Partnership Physical Therapist CurrentSince Oct 6, 2021 Accepting new patients

Locations

141 Atrium Way
Columbia, SC 29223
Phone (803) 788-8484

1787 S Lake Dr
Ste H
Lexington, SC 29073
Phone (803) 957-0404

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1114574670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 ATRIUM WAY",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236301",
            "telephone_number": "803-957-0404",
            "fax_number": "803-957-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 S LAKE DR STE H",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290736736",
            "telephone_number": "803-957-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2191 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861532",
            "country_code": "US",
            "telephone_number": "401-681-4885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARRANT",
        "first_name": "PHILIP",
        "middle_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT03215",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10960",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.