Active NPI
Tyson Garrett King, OTD, OTR/L
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1407691009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 26252
- Practice address
- 2051 Marengo St
Los Angeles, CA 90033-1352 - Phone
- (323) 409-1000
- NPI assigned
- Jun 26, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 26252 | CA | Primary |
Addresses
Primary practice location
2051 Marengo St
Los Angeles, CA 90033-1352
Mailing address
1255 Norman Chapel Rd NW
Cleveland, TN 37312-3537
Phone (423) 790-2723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
24441 Calle Sonora
Laguna Woods, CA 92637-7714
Phone (949) 243-5710
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26252 | CA | MD | Clinical Social Worker |
Organizations & group practices 1
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": "1719360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1407691009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 NORMAN CHAPEL RD NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373123537",
"telephone_number": "423-790-2723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331352",
"telephone_number": "323-409-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "TYSON",
"middle_name": "GARRETT",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-26",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "26252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.