Individual provider Active NPI

Tyler Grissom, PHYSICAL THERAPIST

  • Physical Therapist
  • Cary, NC
National Provider Identifier
1265317929
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24237 Issued in NC
Practice address
3700 NW Cary Pkwy Ste 110
Cary, NC 27513-8446
Phone
(919) 319-3649
Fax
(919) 319-3651
NPI assigned
Aug 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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 P24237 NC Primary

Addresses

Primary practice location

3700 NW Cary Pkwy Ste 110
Cary, NC 27513-8446

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105003194 NC Practitioner - Physical Therapist in Private Practice 7517457823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports and More Physical Therapy IncGroup PAC ID 4385618594, 13 clinicians

Practice addresses (Care Compare)

3700 NW Cary Pkwy
Suite 110
Cary, NC 27513-8446
Phone (919) 319-3649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24237NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & More Physical Therapy, Inc. Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients

Locations

3700 NW Cary Pkwy
Ste 110
Cary, NC 27513
Phone (919) 319-3649

8300 Health Park
Ste 127
Raleigh, NC 27615
Phone (919) 845-6160

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1265317929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 NW CARY PKWY STE 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138446",
            "telephone_number": "919-319-3649",
            "fax_number": "919-319-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "TYLER",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.