Active NPI
Taryn Dyess, COTA/L
- Specialist
- Petal, MS
National Provider Identifier
1669857967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- TA2646
- Practice address
- 24 Trystan Dr
Petal, MS 39465-2839 - Phone
- (601) 408-1150
- NPI assigned
- Jul 28, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | TA2646 | MS | Primary |
Addresses
Primary practice location
24 Trystan Dr
Petal, MS 39465-2839
Mailing address
24 Trystan Dr
Petal, MS 39465-2839
Phone (601) 408-1150
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA2646 | MS | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1669857967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 TRYSTAN DR",
"city": "PETAL",
"state": "MS",
"postal_code": "394652839",
"telephone_number": "601-408-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 TRYSTAN DR",
"city": "PETAL",
"state": "MS",
"postal_code": "394652839",
"telephone_number": "601-408-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYESS",
"first_name": "TARYN",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-28",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MS",
"license": "TA2646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petal, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.