Active NPI
Tylor Wayne Bennett, PT, DPT
- Physical Therapist
- Aurora, CO
National Provider Identifier
1518583616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17001
- Practice address
- 14400 E Jewell Ave
Aurora, CO 80012-5689 - Phone
- (303) 283-5314
- NPI assigned
- Jun 24, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 17001 | CO | Primary |
Addresses
Primary practice location
14400 E Jewell Ave
Aurora, CO 80012-5689
Mailing address
4284 Trail Boss Dr Ste 130
Castle Rock, CO 80104-7521
Phone (303) 663-8086
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 |
|---|---|---|---|
| 17001 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1518583616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4284 TRAIL BOSS DR STE 130",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801047521",
"telephone_number": "303-663-8086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14400 E JEWELL AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800125689",
"telephone_number": "303-283-5314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "TYLOR",
"middle_name": "WAYNE",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-24",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "17001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.