Individual provider Active NPI

Tyler Keith McCurry, D.O.

  • General Practice Physician
  • Cleveland, TN
National Provider Identifier
1700129244
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
DO2887 Issued in TN
Practice address
2253 Chambliss Ave NW Ste 101
Cleveland, TN 37311-3861
Phone
(423) 473-7475
Fax
(423) 559-9152
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X DO2887 TN Primary

Addresses

Primary practice location

2253 Chambliss Ave NW Ste 101
Cleveland, TN 37311-3861

Mailing address

2253 Chambliss Ave NW Ste 101
Cleveland, TN 37311-3861
Phone (423) 473-7475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601002984 TN Practitioner - Family Practice 9032418959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2887TNMDGeneral Practice Physician
2887TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Kaful Double Portion Family Practice, Inc CurrentSince Jun 1, 2020 Accepting new patients

Locations

3740 Ocoee Pl NW
Ste 101
Cleveland, TN 37312
Phone (423) 339-7107

Organizations & group practices 1

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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1700129244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-473-7475",
            "fax_number": "423-559-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-473-7475",
            "fax_number": "423-559-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCURRY",
        "first_name": "TYLER",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "DO2887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.