Active NPI
Tyler Nichols, PT, DPT
- Physical Therapist
- Mountain Home, TN
National Provider Identifier
1407742794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15444
- Practice address
- 809 Lamont St
Mountain Home, TN 37684 - Phone
- (423) 926-1171
- NPI assigned
- Jun 14, 2025
- Last updated
- Jun 14, 2025
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15444 | TN | Primary |
Addresses
Primary practice location
809 Lamont St
Mountain Home, TN 37684
Mailing address
133 Boone Ridge Dr Apt 156
Johnson City, TN 37615
Phone (423) 213-6003
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15444 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749859200000",
"number": "1407742794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 BOONE RIDGE DR APT 156",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "37615",
"telephone_number": "423-213-6003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 LAMONT ST",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-926-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "TYLER",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-14",
"last_updated": "2025-06-14",
"certification_date": "2025-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "15444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.