Individual provider Active NPI

Tyler Douglas, EMT

  • Rehabilitation Practitioner
  • Morgan Hill, CA
National Provider Identifier
1295510899
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
17060 Monterey Rd
Morgan Hill, CA 95037-3636
Phone
(408) 379-3790
NPI assigned
Aug 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E175535 CA
Case Manager/Care Coordinator 171M00000X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

17060 Monterey Rd
Morgan Hill, CA 95037-3636

Mailing address

330 Heidi CT
Morgan Hill, CA 95037-4208

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
E175535CAMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1295510899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HEIDI CT",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950374208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17060 MONTEREY RD",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950373636",
            "telephone_number": "408-379-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "TYLER",
        "credential": "EMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-30",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E175535",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.