Tyler J. Elam, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04118 Issued in KY

Practice address

645 Interstate Dr
Grayson, KY 41143-1704

Phone

(606) 474-0669

Fax

(606) 474-0376

NPI assigned

Mar 13, 2014

Last updated

Sep 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lewis County Primary Care Center, IncGroup PAC ID 1153311774, 86 clinicians

Kentuckyone Health Medical Group IncGroup PAC ID 8820993702, 260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph East Hospital, Lexington, KY, CCN 180143
• Clark Regional Medical Center Hospital, Winchester, KY, CCN 180092

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Lewis County Primary Care Center, Inc.

  dba PrimaryPlus

  • Federally Qualified Health Center (FQHC)
  • Vanceburg, KY
  • NPI 1457303802
  Medicare reassignment Care Compare group NPD
• Kentuckyone Health Medical Group, Inc.

  dba CHI Saint Joseph Medical Group

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1104875970
  Medicare reassignment Care Compare group
• Kentuckyone Health Medical Group, Inc.

  dba CHI Saint Joseph Medical Group

  • General Practice Physician
  • Lexington, KY
  • NPI 1902238694
  NPD
• Lewis County Primary Care Center, Inc.

  dba PrimaryPlus - Morehead

  • Federally Qualified Health Center (FQHC)
  • Morehead, KY
  • NPI 1215643440
  NPD

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

• Kentucky Hospital, LLC

  dba Clark Regional Medical Center

  • General Acute Care Hospital
  • Winchester, KY
  • NPI 1811213994
  Care Compare affiliation
• Saint Joseph Health System, Inc

  dba CHI Saint Joseph East

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1447457775
  Care Compare affiliation

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1144646209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835",
            "fax_number": "859-744-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 INTERSTATE DR",
            "city": "GRAYSON",
            "state": "KY",
            "postal_code": "411431704",
            "telephone_number": "606-474-0669",
            "fax_number": "606-474-0376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Old Viking Dr",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403517579",
            "country_code": "US",
            "telephone_number": "606-784-2774",
            "fax_number": "606-780-1118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1850 Bypass Rd",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "KY",
            "postal_code": "403912300",
            "country_code": "US",
            "telephone_number": "859-744-5111",
            "fax_number": "859-744-1177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "255 Old Viking Dr",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403517579",
            "country_code": "US",
            "telephone_number": "606-784-2774",
            "fax_number": "606-780-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELAM",
        "first_name": "TYLER",
        "middle_name": "J.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-13",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE   MMS",
            "identifier": "K247850",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "04118",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100472630",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Nicole Dollar, PA-C
• Meagan Rhea Doyle, MD
• Christopher Dunn, OTR/L
• Emily Dyer
• Kristy Danielle Dyer, PT
• Laurie Elliott
• Enspired Wellness LLC (Grayson Family Health)
• Aleah Evans, LMT
• Karlena Evans
• Shelby Alexis Fairchild

• Family Medicine Physician in Grayson, KY
• Providers in Grayson, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.