Tyler Justin Jensen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

129 Walker Hill St
Crossville, TN 38555-5484

Phone

(931) 787-1715

Fax

(931) 218-6996

NPI assigned

Jun 4, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tyler Justin Service Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Spine Orthopedic & Sports Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Provo, UT
  • NPI 1447275946

  Physical Therapist

  NPD

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1306284062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 WALKER HILL ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385555484",
            "telephone_number": "931-787-1715",
            "fax_number": "931-218-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 WALKER HILL ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385555484",
            "telephone_number": "931-787-1715",
            "fax_number": "931-218-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8751 W Charleston Blvd",
            "address_2": "#270",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891175480",
            "country_code": "US",
            "telephone_number": "702-982-2232",
            "fax_number": "702-982-2237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "TYLER",
        "middle_name": "JUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8515460-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "SERVICE",
            "middle_name": "JUSTIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexie Inman, OTR/L
• Innovative Restorations LLC
• Iriz Perez
• Donathan M Ivey, MD
• Holly Ann Jackle, LCSW
• John Smith Professional Pharmacy, Inc.
• Shannon Johns, SLP-CCC
• Johnson Family Medicine LLC
• Deborah Ann Johnson, EDS LPC MHSP
• Grayson Banks Johnson, DC

• Physical Therapist in Crossville, TN
• Providers in Crossville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.