Individual provider Active NPI

Dixie Star Tyer, OT

  • Occupational Therapist
  • Ridgeland, MS
National Provider Identifier
1144902818
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-4039 Issued in MS
Practice address
115 W Jackson St Ste 1D
Ridgeland, MS 39157-2428
Phone
(601) 853-9747
NPI assigned
Aug 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-4039 MS Primary

Addresses

Primary practice location

115 W Jackson St Ste 1D
Ridgeland, MS 39157-2428

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 777-6236

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
OT-4039MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Occupational Therapist CurrentSince Aug 7, 2023 Accepting new patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1476 W Government St
#B
Brandon, MS 39042
Phone (601) 914-6440

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

115 W Jackson St
Ste 1D
Ridgeland, MS 39157
Phone (601) 853-9747

950 E County Line Rd
Ste E
Ridgeland, MS 39157
Phone (601) 853-8747

Organizations & group practices 2

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": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1144902818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-777-6236",
            "fax_number": "423-777-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W JACKSON ST STE 1D",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572428",
            "telephone_number": "601-853-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYER",
        "first_name": "DIXIE",
        "middle_name": "STAR",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-4039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.

Verify at the official NPI Registry.