Tyler Aaron Shupe, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62736 Issued in OR

Practice address

170 Melton Rd
Creswell, OR 97426

Phone

(541) 895-2152

Fax

(541) 895-2215

NPI assigned

Jul 24, 2012

Last updated

Aug 7, 2018By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• On the Mend on the Move Physical Therapy

  • Physical Therapist
  • Mesa, AZ
  • NPI 1871993659
  NPD
• On the Mend on the Move Physical Therapy, Inc.

  • Physical Therapist
  • Mesa, AZ
  • NPI 1528011178
  NPD
• Neuropsychological Services of Oregon, LLC

  • Clinical Neuropsychologist
  • Creswell, OR
  • NPI 1164820478
  NPD (past)
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1356696660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MELTON RD",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "97426",
            "telephone_number": "541-895-2152",
            "fax_number": "541-895-2215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7525 E Broadway Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852081156",
            "country_code": "US",
            "telephone_number": "480-354-2911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUPE",
        "first_name": "TYLER",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "9868PT",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reroot Massage Therapy and Energy Work, LLC (ReRoot Massage Therapy)
• Sarah Rose
• David Sanderbrink
• Barbara Schwan
• Elena D Shore, LCSW
• Raema Lynn Smith, PT
• Jennifer Sullivan
• Tamara Blum DC PC (Creswell Chiropractic)
• Therapeutic Associates Inc (TAI - Creswell Physical Therapy)
• Therapeutic Associates, Inc (TAI - Creswell Physical Therapy)

• Physical Therapist in Creswell, OR
• Providers in Creswell, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.