Tyler Williamson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

580 E 9400 S
103
Sandy, UT 84070-8407

Phone

(225) 939-8180

NPI assigned

Jun 9, 2014

Last updated

Mar 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Adult Services

  dba Speech-Language-Hearing Clinic

  • Speech-Language Pathologist
  • Salt Lake City, UT
  • NPI 1982135984
  NPD

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1255744017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 E 9400 S # 103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840706237",
            "telephone_number": "225-939-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 E 9400 S",
            "address_2": "103",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708407",
            "telephone_number": "225-939-8180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1160 E 3900 S",
            "address_2": "SUITE 5000",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841241202",
            "country_code": "US",
            "telephone_number": "801-262-8486",
            "fax_number": "801-284-8699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "TYLER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL LICENSING",
            "identifier": "9066323-1206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marin Williams, DPT
• Molly K Williams, DPT
• Natalee Mae Williams
• Rick E. Williams, RPH
• Bonnie Williamson, MPT
• Deborah Ann Willoughby, M.S. CCC-SLP
• Willow Creek Chiropractic Inc.
• Willow Creek Dental
• Valerie Jean Wilson, ACMHC
• Chelsey Maree Winegar

• Physician Assistant in Sandy, UT
• Providers in Sandy, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.