Tyler Jordan Phillips

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05015653A Issued in IN

Practice address

1841 E Summit St
Crown Point, IN 46307-2768

Phone

(219) 801-7777

Fax

(219) 801-7677

NPI assigned

Aug 12, 2024

Last updated

Aug 12, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Track Physical Therapy LLCGroup PAC ID 7517148745, 12 clinicians

Practice addresses (Care Compare)

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.

• Fast Track Physical Therapy LLC

  • Physical Therapist
  • Avon, IN
  • NPI 1992005540
  Medicare reassignment Care Compare group NPD
• Physiopoint Therapy

  dba PhysioPoint Therapy & Wellness

  • Physical Therapy Clinic/Center
  • Crown Point, IN
  • NPI 1508279092

  Physical Therapist

  NPD
• Hospice of America, Inc

  • Clinic/Center
  • Crown Point, IN
  • NPI 1184281214
  NPD (past)

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1427889351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 E SUMMIT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072768",
            "telephone_number": "219-801-7777",
            "fax_number": "219-801-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 E SUMMIT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463072768",
            "telephone_number": "219-801-7777",
            "fax_number": "219-801-7677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Morthland Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463854638",
            "country_code": "US",
            "telephone_number": "219-801-7777",
            "fax_number": "219-801-7677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TYLER",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015653A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Pettit
• Zachary Pflaum, LMHC-A
• Casey Pflughoeft, MSW
• Amy Renae Philipps, FNP-C
• Thomee Phillips
• Physiopoint Therapy (PhysioPoint Therapy & Wellness)
• Julie Ann Pierce, FNP
• Maxine Pierce, RBT
• Amanda Pimentel, PA-C
• Pamela R Pinchok, PA-C

• Physical Therapist in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.