Individual provider Active NPI

Tyrone Edward Pitt Jr., DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Mooresville, NC
National Provider Identifier
1659159143
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
P22321 Issued in NC
Practice address
136 Corporate Park Dr Ste a
Mooresville, NC 28117-6960
Phone
(704) 360-2796
Fax
(704) 360-2798
NPI assigned
Sep 18, 2023
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X P22321 NC Primary

Addresses

Primary practice location

136 Corporate Park Dr Ste a
Mooresville, NC 28117-6960

Mailing address

136 Corporate Park Dr Ste a
Mooresville, NC 28117-6960
Phone (704) 360-2796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119002143 NC Practitioner - Physical Therapist in Private Practice 4284086729 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saylor Physical TherapyGroup PAC ID 4486814381, 2 clinicians

Practice addresses (Care Compare)

136 Corporate Park Dr
Suite a
Mooresville, NC 28117-6960
Phone (704) 360-2796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P22321NCMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jul 2, 2024 Accepting new patients
Duke University Health System, Inc. CurrentSince Mar 4, 2025 Accepting new patients
Duke University Health System, Inc. Physical Therapist CurrentSince Mar 4, 2025 Accepting new patients
Saylor Physical Therapy CurrentSince Nov 1, 2023 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

136 Corporate Park Dr
Ste A
Mooresville, NC 28117
Phone (704) 360-2796

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1659159143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CORPORATE PARK DR STE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176960",
            "telephone_number": "704-360-2796",
            "fax_number": "704-360-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CORPORATE PARK DR STE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176960",
            "telephone_number": "704-360-2796",
            "fax_number": "704-360-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITT",
        "first_name": "TYRONE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NC",
            "license": "P22321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.