Individual provider Active NPI

Tyler Martin

  • Physical Therapist
  • Newnan, GA
National Provider Identifier
1225782923
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015761 Issued in GA
Practice address
47 Postal Pkwy
Newnan, GA 30263-2885
Phone
(770) 251-7284
NPI assigned
Feb 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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 PT015761 GA Primary

Addresses

Primary practice location

47 Postal Pkwy
Newnan, GA 30263-2885

Mailing address

6397 Lee Hwy
Chattanooga, TN 37421-2564
Phone (423) 238-3473

Other practice location 1

1280 Highway 74 S Ste 210
Peachtree City, GA 30269-3077
Phone (770) 486-6398

Other practice location 2

112 Kia Dr Ste B
LaGrange, GA 30241-3731
Phone (706) 668-6336

Other practice location 3

1111 Lower Fayetteville Rd Ste 2000
Newnan, GA 30265-6506
Phone (770) 251-7284

Other practice location 4

909 S Park St Ste E
Carrollton, GA 30117-4456
Phone (770) 251-7284

Other practice location 5

277 Highway 74 N
Peachtree City, GA 30269-1569
Phone (678) 364-0337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220331000104 GA Practitioner - Physical Therapist in Private Practice 5991191918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

112 Kia Dr
Suite B
Lagrange, GA 30241-3731
Phone (706) 668-6336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Feb 8, 2022 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Feb 8, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Feb 8, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Feb 8, 2022 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Feb 8, 2022 Accepting new patients
Independent Physical Therapy of Georgia , LLC Physical Therapist Past Accepting new patients

Locations

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

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

909 S Park St
Ste E
Carrollton, GA 30117
Phone (770) 251-7284

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

112 Kia Dr
#B
Lagrange, GA 30241
Phone (706) 668-6336

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

3150 Highway 34 E
Ste 207
Newnan, GA 30265
Phone (770) 740-6600

47 Postal Pkwy
Newnan, GA 30263
Phone (770) 252-5279

1111 Lower Fayetteville Rd
Ste 2000
Newnan, GA 30265
Phone (770) 251-7284

1280 Highway 74 S
Ste 210
Peachtree City, GA 30269
Phone (770) 486-6398

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 6

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1225782923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 POSTAL PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302632885",
            "telephone_number": "770-251-7284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 Highway 74 S Ste 210",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302693077",
            "country_code": "US",
            "telephone_number": "770-486-6398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 Kia Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302413731",
            "country_code": "US",
            "telephone_number": "706-668-6336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Lower Fayetteville Rd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302656506",
            "country_code": "US",
            "telephone_number": "770-251-7284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "909 S Park St Ste E",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301174456",
            "country_code": "US",
            "telephone_number": "770-251-7284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "277 Highway 74 N",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302691569",
            "country_code": "US",
            "telephone_number": "678-364-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.