Individual provider Active NPI

Tyler Wade Ray, DPT

  • Physical Therapist
  • Chapel Hill, NC
National Provider Identifier
1679232896
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20894 Issued in NC
Practice address
100 Perkins Dr
Chapel Hill, NC 27514-1783
Phone
(919) 942-3171
NPI assigned
Dec 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P20894 NC Primary

Addresses

Primary practice location

100 Perkins Dr
Chapel Hill, NC 27514-1783

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211228002425 NC Practitioner - Physical Therapist in Private Practice 0345631453 Reassigns benefits to 1 organization
I20240329001898 CA Practitioner - Physical Therapist in Private Practice 0345631453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20894NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Dec 13, 2021 Accepting new patients
Emergeortho PA Physical Therapist CurrentSince Dec 13, 2021 Accepting new patients

Locations

100 Perkins Dr
Chapel Hill, NC 27514
Phone (919) 942-3171

7810 NC 751 Hwy
Durham, NC 27713
Phone (919) 544-7270

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

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": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1679232896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PERKINS DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141783",
            "telephone_number": "919-942-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "TYLER",
        "middle_name": "WADE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.