Individual provider Active NPI

Tyler Thibert

  • Physical Therapist
  • D'Iberville, MS
National Provider Identifier
1235063397
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8178 Issued in MS
Practice address
4016 Cassimer Ave
Diberville, MS 39540-2309
Phone
(228) 280-8120
NPI assigned
Jun 11, 2026
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 8178 MS Primary

Addresses

Primary practice location

4016 Cassimer Ave
Diberville, MS 39540-2309

Mailing address

4016 Cassimer Ave
Diberville, MS 39540-2309
Phone (228) 280-8120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4016 Cassimer Ave
Diberville, MS 39540-2309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Rehabilitation Services LLC Physical Therapist CurrentSince Jun 11, 2026 Accepting new patients

Locations

604 Blue Meadow Rd
Bay St Louis, MS 39520
Phone (228) 280-8120

4016 Cassimer Ave
Diberville, MS 39540
Phone (228) 280-8120

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1781136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1235063397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 CASSIMER AVE",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395402309",
            "telephone_number": "228-280-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 CASSIMER AVE",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395402309",
            "telephone_number": "228-280-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBERT",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-11",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "8178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in D'Iberville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.