Individual provider Active NPI

Tyler Brause, DPT

  • Physical Therapist
  • Bucyrus, OH
National Provider Identifier
1144796376
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-017682 Issued in OH
Practice address
351 S Lane St Ste 1
Bucyrus, OH 44820-2319
Phone
(419) 562-6686
Fax
(419) 562-6625
NPI assigned
Oct 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-017682 OH Primary

Addresses

Primary practice location

351 S Lane St Ste 1
Bucyrus, OH 44820-2319

Mailing address

112 Harcourt Rd Ste 1
Mount Vernon, OH 43050-3944
Phone (740) 392-8811

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-017682OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1144796376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HARCOURT RD STE 1",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503944",
            "telephone_number": "740-392-8811",
            "fax_number": "740-392-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 S LANE ST STE 1",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202319",
            "telephone_number": "419-562-6686",
            "fax_number": "419-562-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUSE",
        "first_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-017682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.