Tyler Matthew Wynn, DPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT016519 Issued in OH

Practice address

151 W Galbraith Rd Ste N2045
Cincinnati, OH 45216-1015

Phone

(513) 418-2735

Fax

(513) 418-2775

NPI assigned

Sep 7, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1336696301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 GLEN ESTE WITHAMSVILLE RD",
            "address_2": "SUITE 1500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451318",
            "telephone_number": "513-753-2133",
            "fax_number": "513-753-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W GALBRAITH RD STE N2045",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452161015",
            "telephone_number": "513-418-2735",
            "fax_number": "513-418-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "TYLER",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "PT016519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A Wynn, LPN
• Mary Ellen Wynn, D.D.S.
• Ryane M Wynn
• Tamarah Lenise Wynn
• Tom M Wynn, RPH
• Thomas James Wynsen
• Wyoming Leasing Co, LLC (Ivy Woods Healthcare Center)
• Wyoming Pharmacy Inc (Compton Medical Pharmacy)
• Wyoming Smile Center LLC
• John D Wyrick, M.D.

• Specialist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.