Individual provider Active NPI

Rodney N. Tyler Jr., OTR/L, CHT

  • Occupational Therapist
  • Moncks Corner, SC
National Provider Identifier
1568473296
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2237 Issued in SC
Practice address
209 W Main St
Moncks Corner, SC 29461-2604
Phone
(843) 899-5374
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2237 SC Primary
Hand Occupational Therapist 225XH1200X 1051100326 SC

Addresses

Primary practice location

209 W Main St
Moncks Corner, SC 29461-2604

Mailing address

104 Macfarren LN
Summerville, SC 29485-4062
Phone (843) 821-9934

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

LicenseStateTypeSpecialty
2237SCMDProsthodontist
1051100326SCMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Strong Physical Therapy LLC Past Accepting new patients
Moncks Corner Physical Therapy, LLC Occupational Therapist PastSince Oct 1, 2002 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1568473296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MACFARREN LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854062",
            "telephone_number": "843-821-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294612604",
            "telephone_number": "843-899-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "RODNEY",
        "middle_name": "N.",
        "name_suffix": "Jr.",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2237",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "SC",
            "license": "1051100326",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.