Active NPI
Tyler Jepson, P.T.
- Physical Therapist
- Ontario, OR
National Provider Identifier
1487946521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-2138
- Practice address
- 1182 SW 4TH Avenue
Ontario, OR 97914 - Phone
- (541) 881-0970
- Fax
- (541) 881-0971
- NPI assigned
- May 9, 2011
- Last updated
- May 9, 2011
- 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 | PT-2138 | ID | Primary |
Addresses
Primary practice location
1182 SW 4TH Avenue
Ontario, OR 97914
Mailing address
1182 SW 4TH Avenue
Ontario, OR 97914
Phone (541) 881-0970
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT-2138 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1487946521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1182 SW 4TH AVENUE",
"city": "ONTARIO",
"state": "OR",
"postal_code": "97914",
"telephone_number": "541-881-0970",
"fax_number": "541-881-0971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1182 SW 4TH AVENUE",
"city": "ONTARIO",
"state": "OR",
"postal_code": "97914",
"telephone_number": "541-881-0970",
"fax_number": "541-881-0971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEPSON",
"first_name": "TYLER",
"name_prefix": "Dr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-09",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-2138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.