Individual provider Active NPI

Tyler Peeler, OT

  • Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1336807908
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
14516 Issued in NC
Practice address
9216 Ardrey Kell Rd Ste 300
Charlotte, NC 28277-4954
Phone
(980) 556-7330
NPI assigned
Dec 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT.6371OT SC
Occupational Therapist 225X00000X 14516 NC Primary

Addresses

Primary practice location

9216 Ardrey Kell Rd Ste 300
Charlotte, NC 28277-4954

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224

Other practice location 1

214 18th St SE
Hickory, NC 28602-1363
Phone (828) 485-2160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214002186 NC Practitioner - Occupational Therapist in Private Practice 4587054150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

9216 Ardrey Kell Rd
Suite 300
Charlotte, NC 28277-4954
Phone (980) 556-7330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14516NCMDOccupational Therapist
OT.6371OTSCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab North Carolina LLC CurrentSince Dec 1, 2021 Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

1129 E Marion St
Shelby, NC 28150
Phone (704) 471-0001

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 2

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1336807908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9216 ARDREY KELL RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774954",
            "telephone_number": "980-556-7330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 18th St SE",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286021363",
            "country_code": "US",
            "telephone_number": "828-485-2160",
            "fax_number": "828-485-2161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEELER",
        "first_name": "TYLER",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-01",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "OT.6371OT",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.