Individual provider Active NPI

Tyler Williams, DPT

  • Physical Therapist
  • Oakland, CA
National Provider Identifier
1386873305
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
35558 Issued in CA
Practice address
4341 Piedmont Ave
Suite 201
Oakland, CA 94611-4766
Phone
(208) 921-3372
NPI assigned
Jul 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 35558 CA Primary

Addresses

Primary practice location

4341 Piedmont Ave
Suite 201
Oakland, CA 94611-4766

Mailing address

4341 Piedmont Ave
Suite 201
Oakland, CA 94611-4766
Phone (208) 921-3372

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
35558CAMDOncology Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Presidio Sport & Medicine, Inc. Physical Therapist PastSince May 4, 2002 Accepting new patients
Sports & Orthopedic Leaders Physical Therapy, Inc Physical Therapist PastSince Oct 1, 2009 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1386873305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE",
            "address_2": "SUITE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114766",
            "telephone_number": "208-921-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE",
            "address_2": "SUITE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114766",
            "telephone_number": "208-921-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYLER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-12",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "35558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.