Active NPI
Tyler Owens, PTA, ATC
- Physical Therapy Assistant
- Clanton, AL
National Provider Identifier
1134524820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 11915
- Practice address
- 674 Ollie Ave
Clanton, AL 35045-2246 - Phone
- (205) 280-1100
- Fax
- (205) 280-1575
- NPI assigned
- Oct 24, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 11915 | AL | Primary |
| Athletic Trainer | 2255A2300X | 1503 | AL |
Addresses
Primary practice location
674 Ollie Ave
Clanton, AL 35045-2246
Mailing address
674 Ollie Ave
Clanton, AL 35045-2246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1503 | AL | MD | General Practice Dentistry |
| 11915 | AL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1134524820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "674 OLLIE AVE",
"city": "CLANTON",
"state": "AL",
"postal_code": "350452246",
"fax_number": "205-280-1575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "674 OLLIE AVE",
"city": "CLANTON",
"state": "AL",
"postal_code": "350452246",
"telephone_number": "205-280-1100",
"fax_number": "205-280-1575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OWENS",
"first_name": "TYLER",
"credential": "PTA, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-24",
"last_updated": "2024-08-29",
"certification_date": "2024-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "11915",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "1503",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clanton, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.