Tyler Austin Greener, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8720 Issued in ID

Practice address

1739 S Jade Way Ste 110
Meridian, ID 83642-5898

Phone

(208) 207-5454

Fax

(208) 600-6064

NPI assigned

Jun 1, 2023

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 ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Current Physical Therapy CaldwellGroup PAC ID 5698138683, 5 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 and National Provider Directory roles.

• Current Physical Therapy Caldwell

  • Physical Therapist
  • Caldwell, ID
  • NPI 1598456295
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1497448716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 S JADE WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425898",
            "telephone_number": "208-207-5454",
            "fax_number": "208-600-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 S JADE WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425898",
            "telephone_number": "208-207-5454",
            "fax_number": "208-600-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENER",
        "first_name": "TYLER",
        "middle_name": "AUSTIN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Limits Counseling LLC
• Debra W. Greeff, LMSW
• Green Zone Transportation LLC
• Avery Green, DPT
• Stephen Lloyd Green, M.D.
• Susan Rene' Greenough, L.P.C.
• Barney Greenspan, PH.D.
• Greenstaff Medical Home Care LLC
• John A Greer, M.D.
• Greg Steiner PC

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.