Individual provider Active NPI

Tyler Windham Hudgins, PT, DPT

  • Physical Therapist
  • Southaven, MS
National Provider Identifier
1295248649
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7826 Issued in MS
Practice address
3451 Goodman Rd E Ste 108
Southaven, MS 38672-9305
Phone
(662) 890-6953
NPI assigned
Nov 8, 2017
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH8701 AL
Physical Therapist 225100000X PT7826 MS Primary

Addresses

Primary practice location

3451 Goodman Rd E Ste 108
Southaven, MS 38672-9305

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 777-6236

Other practice location 1

12110 County Line Rd Ste B
Madison, AL 35756-2009
Phone (256) 232-9001

Other practice location 2

22292 US Highway 72
Athens, AL 35613
Phone (256) 233-2313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180207002079 AL Practitioner - Physical Therapist in Private Practice 7113287368 Reassigns benefits to 3 organizations
I20241106000040 MS Practitioner - Physical Therapist in Private Practice 7113287368 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

181 Hughes Rd
Suite 1B
Madison, AL 35758-1146
Phone (256) 850-1155

3451 Goodman Rd E
Suite 108
Southaven, MS 38672-9305
Phone (662) 890-6953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7826MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Jun 15, 2022 Accepting new patients
Drayer Physical Therapy Alabama LLC CurrentSince Nov 6, 2017 Accepting new patients
Drayer Physical Therapy-Alabama, LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Aug 10, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jun 15, 2022 Accepting new patients
Drayer Physical Therapy-Alabama, LLC Physical Therapist CurrentSince Nov 6, 2017 Accepting new patients
Benchmark Physical Therapy of Mississippi LLC Physical Therapist CurrentSince Aug 10, 2024 Accepting new patients
Benchmark Physical Therapy of Alabama, LLC Physical Therapist CurrentSince Jun 10, 2018 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients
Benchmark Physical Therapy of Alabama, LLC Physical Therapist Past Accepting new patients

Locations

22292 US Highway 72
Athens, AL 35613
Phone (256) 230-6994

153 Narrows Pkwy
Ste 101
Birmingham, AL 35242
Phone (205) 640-4881

2215 Decatur Hwy
Ste 125
Gardendale, AL 35071
Phone (205) 285-8790

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

4601 Whitesburg Dr SE
Ste 102
Huntsville, AL 35802
Phone (256) 883-1734

12110 County Line Rd
Ste B
Madison, AL 35756
Phone (256) 232-9001

181 Hughes Rd
Ste 1B
Madison, AL 35758
Phone (256) 850-1155

2846 Moody Pkwy
Ste 200
Moody, AL 35004
Phone (205) 640-0257

199 N Brookmoore Dr
Columbus, MS 39705
Phone (662) 798-0108

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

4010 Bienville Blvd
Unit E
Ocean Springs, MS 39564
Phone (228) 300-6001

3451 Goodman Rd E
Ste 108
Southaven, MS 38672
Phone (662) 253-9060

8205 Presidents Dr
#2
Hummelstown, PA 17036
Phone (717) 803-2560

Organizations & group practices 10

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": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1295248649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-777-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E STE 108",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729305",
            "telephone_number": "662-890-6953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12110 County Line Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "AL",
            "postal_code": "357562009",
            "country_code": "US",
            "telephone_number": "256-232-9001",
            "fax_number": "256-233-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22292 US Highway 72",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "35613",
            "country_code": "US",
            "telephone_number": "256-233-2313",
            "fax_number": "256-233-8577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDGINS",
        "first_name": "TYLER",
        "middle_name": "WINDHAM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-08",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.