Tyler Steven Eubanks, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P14396 Issued in NC

Practice address

4909 Green Rd
Raleigh, NC 27616-3418

Phone

(919) 790-0288

NPI assigned

Sep 25, 2013

Sex

Male

Sole proprietor

Yes

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 NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1629568647

  Physical Therapist

  Medicare reassignment NPD
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1528683935
  NPD

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1629404330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 PURPLEHORSE WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063750",
            "telephone_number": "919-412-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 GREEN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163418",
            "telephone_number": "919-790-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "TYLER",
        "middle_name": "STEVEN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P14396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Etta'S Residential Services and Supports, Inc.
• Halima Ettalbi
• Carly Nassereh Ettefagh, MSOT, OTR/L
• Holly Lucas Eubanks, NP
• Kristen Ashley Eubanks
• Eunoia Holistic Healing, PLLC
• Adrienne Latrice Eure, LCSWA
• Hannah N Eure
• Susan Lara Eure, PHARM. D
• Emily Amoni Eustis, PA-C

• Physical Therapist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.