Tyson Ray Fernstrom, DPT

Key facts

NPI

1689330847

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

14282651-2401 (UT)

Practice address

4095 E Pony Express Pwky
Ste 6
Eagle Mountain, UT 84005

Phone

(801) 459-7545

NPI assigned

Nov 11, 2021

Sex

Male

Sole proprietor

Yes

Organizations & group practices 3

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.

• Jerl, Inc. Physical Therapy Clinic/Center · Dripping Springs, TX · NPI 1366631848
  Medicare reassignment Care Compare group NPD SINGLE SPECIALTY · TX
• FST Physical Therapy PLLC Physical Therapy Clinic/Center · Eagle Mountain, UT · NPI 1508788662
  NPD (past) Authorized official
• Jerl, Inc. Physical Therapy Clinic/Center · Dripping Springs, TX · NPI 1255109229
  NPD

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jerl Inc (9 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 29, 2026.

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1689330847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 E PONY EXPRESS PWKY",
            "address_2": "STE 6",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "84005",
            "telephone_number": "801-459-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 E PONY EXPRESS PWKY",
            "address_2": "STE 6",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "84005",
            "telephone_number": "801-459-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNSTROM",
        "first_name": "TYSON",
        "middle_name": "RAY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-11",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "14282651-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Mountain, UT

• Steven Len Embley, D.O.
• Arlene Erickson, MS-CCC-SLP
• Dacya Erickson
• Essential Injections P.C.
• Ryan Fairhurst, SSW
• Skyler D Fischer, MSW
• Camrie Lynn Fletcher, M.S. CCC-SLP
• Jacob Chase Fowler, PHARMD
• FST Physical Therapy PLLC
• Madeline Rose Gabor

All providers in Eagle Mountain, UT · Physical Therapist in Utah