Individual provider Active NPI

Tyler Little, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1417468992
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0009197 Issued in CO
Practice address
111 Doctors Dr
Greenville, SC 29605-5622
Phone
(864) 797-7150
Fax
(864) 797-7155
NPI assigned
Oct 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 3967 SC
Surgical Physician Assistant 363AS0400X PA11681 TX
Physician Assistant 363A00000X PA.0009197 CO Primary

Addresses

Primary practice location

111 Doctors Dr
Greenville, SC 29605-5622

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (806) 743-2898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210727001039 SC Practitioner - Physician Assistant 4486912581 Reassigns benefits to 1 organization
I20251007004418 CO Practitioner - Physician Assistant 4486912581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portercare Adventist Health SystemGroup PAC ID 0941110886, 770 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

145 Inverness Dr E
Englewood, CO 80112-5171
Phone (303) 697-7463

2350 Meadows Blvd
Castle Rock, CO 80109-8405
Phone (720) 455-0650

2353 Meadows Blvd
Suite 300
Castle Rock, CO 80109-8405
Phone (720) 455-3750

2360 Meadows Blvd
Suite 300
Castle Rock, CO 80109-8405
Phone (303) 715-7106

2490 W 26TH Ave
Denver, CO 80211-5385
Phone (720) 694-8686

2535 S Downing St
Denver, CO 80210-5850
Phone (303) 778-5797

Hospital & facility affiliations

  • Adventhealth Castle Rock Hospital, Castle Rock, CO, CCN 060125
  • AdventHealth Parker Hospital, Parker, CO, CCN 060114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3967SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 6, 2021 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 6, 2021 Accepting new patients
Portercare Adventist Health System CurrentSince Aug 25, 2025 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 25, 2025 Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Locations

145 Inverness Dr E
Ste 220
Englewood, CO 80112
Phone (303) 369-6060

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

111 Doctors Dr
Greenville, SC 29605
Phone (864) 242-4683

Organizations & group practices 7

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1417468992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055622",
            "telephone_number": "864-797-7150",
            "fax_number": "864-797-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-23",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3967",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA11681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0009197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.