Active NPI
Tyler McClurg, DPT
- Physical Therapist
- Concord, NC
National Provider Identifier
1225426737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15467
- Practice address
- 110 Lake Concord Rd NE
Concord, NC 28025-2918 - Phone
- (704) 792-2672
- NPI assigned
- Jan 6, 2015
- Last updated
- Feb 11, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15467 | NC | Primary |
Addresses
Primary practice location
110 Lake Concord Rd NE
Concord, NC 28025-2918
Mailing address
225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15467 | NC | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1225426737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 BALDWIN AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043109",
"telephone_number": "704-376-1605",
"fax_number": "704-335-8448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 LAKE CONCORD RD NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252918",
"telephone_number": "704-792-2672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLURG",
"first_name": "TYLER",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-06",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "15467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.