Tyrone Davis

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2898 Issued in SC

Practice address

201 Brightwater Dr
Myrtle Beach, SC 29579-8298

Phone

(843) 903-8958

NPI assigned

Jan 29, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1669710489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BREAKERS DR UNIT 232",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BRIGHTWATER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295798298",
            "telephone_number": "843-903-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TYRONE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "2898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindley Brooke Davis, M.S., CF-SLP
• Mercedes Zimmerman Davis, PA-C
• Morgan Davis, BCBA
• Rochelle L Davis, LCSW-CP
• Stanley Bernard Davis Jr., BA
• Tima R. Deal, OTR
• Mark Tracy Dean, OD
• Deane Counseling LLC
• Thais Deane, LCSW
• Suzanne H Deckelbaum, NP

• Physical Therapy Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.