NPIMap

Individual provider Active NPI

Ty Mauldin

  • Student in an Organized Health Care Education/Training Program
  • Sioux Falls, SD
National Provider Identifier
1134880453
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1316 W Wicklow CT
Sioux Falls, SD 57108-3252
Phone
(605) 836-1227
NPI assigned
Jan 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1316 W Wicklow CT
Sioux Falls, SD 57108-3252

Mailing address

1316 W Wicklow CT
Sioux Falls, SD 57108-3252
Phone (605) 836-1227

Other identifiers 2

IdentifierTypeStateIssuer
96440OtherCAACCME (ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION)
5020425893002OtherTNSS NETWORK ALLIANCE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ty.mauldin.1@23204.direct.athenahealth.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Perfusion USA, LLC CurrentSince Feb 27, 2022 Accepting new patients
Brennan Chiropractic PC Current Accepting new patients
Synergy Health Group PC Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ty.mauldin.1@23204.direct.athenahealth.com

Organizations & group practices 3

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": "1641600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1134880453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 W WICKLOW CT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083252",
            "telephone_number": "605-836-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 W WICKLOW CT",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571083252",
            "telephone_number": "605-836-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAULDIN",
        "first_name": "TY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-08",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCME (ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION)",
            "identifier": "96440",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SS NETWORK ALLIANCE #",
            "identifier": "5020425893002",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ty.mauldin.1@23204.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1316 W Wicklow Ct",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571083252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.