Active NPI
Tyler Dorsey, PTA, ATC
- Physical Therapy Assistant
- Charleston, WV
National Provider Identifier
1144945114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 002419
- Practice address
- 1611 Quarrier St Apt a
Charleston, WV 25311-2135 - Phone
- (304) 667-0715
- NPI assigned
- Oct 11, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 002419 | WV | |
| Physical Therapy Assistant | 225200000X | 002419 | WV | Primary |
Addresses
Primary practice location
1611 Quarrier St Apt a
Charleston, WV 25311-2135
Mailing address
181 Heatherton Dr
Lewisburg, WV 24901-9623
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 |
|---|---|---|---|
| 002419 | WV | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1144945114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 HEATHERTON DR",
"city": "LEWISBURG",
"state": "WV",
"postal_code": "249019623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 QUARRIER ST APT A",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253112135",
"telephone_number": "304-667-0715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORSEY",
"first_name": "TYLER",
"credential": "PTA, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-11",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "WV",
"license": "002419",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WV",
"license": "002419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.