Active NPI
Ty James McLaughlin, P.T.
- Physical Therapist
- Prescott, AZ
National Provider Identifier
1720378755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT29211
- Practice address
- 3117 Stillwater Dr
Prescott, AZ 86305-7164 - Phone
- (928) 442-0005
- NPI assigned
- Apr 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT29211 | CA | Primary |
Addresses
Primary practice location
3117 Stillwater Dr
Prescott, AZ 86305-7164
Mailing address
11238 Casper CV
Beaumont, CA 92223-6235
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT29211 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1720378755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11238 CASPER CV",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922236235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3117 STILLWATER DR",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863057164",
"telephone_number": "928-442-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLAUGHLIN",
"first_name": "TY",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-11",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT29211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.