Individual provider Active NPI

Tyler James Thornburg, PT, DPT

  • Physical Therapist
  • Chantilly, VA
National Provider Identifier
1790392058
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28140 Issued in MD
Practice address
3925 Downs Dr
Chantilly, VA 20151-3308
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Sep 30, 2020
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT004346 WV
Physical Therapist 225100000X 28140 MD Primary

Addresses

Primary practice location

3925 Downs Dr
Chantilly, VA 20151-3308

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

9708 Belair Rd
Baltimore, MD 21236-1108
Phone (877) 407-3422

Other practice location 2

9885 Greenbelt Rd
Lanham, MD 20706-2302
Phone (877) 407-3422

Other practice location 3

1207 Liberty Rd # 106
Eldersburg, MD 21784-6574
Phone (410) 549-5700

Other practice location 4

7819 Rocky Springs Rd
Frederick, MD 21702-2824
Phone (877) 407-3422

Other practice location 5

6451 N Charles St
Baltimore, MD 21212-1010
Phone (877) 407-3422

Other practice location 6

11665 Doolittle Dr
Waldorf, MD 20602-2898
Phone (877) 407-3422

Electronic endpoints 8

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT MD LLC
CONNECT URL https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab OT CT, LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20201015001692 MD Practitioner - Physical Therapist in Private Practice 0345660197 Reassigns benefits to 2 organizations
I20201015002024 DC Practitioner - Physical Therapist in Private Practice 0345660197 Reassigns benefits to 2 organizations
I20250929002928 PA Practitioner - Physical Therapist in Private Practice 0345660197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT MD LLCGroup PAC ID 6709028822, 92 clinicians

Practice addresses (Care Compare)

6451 N Charles St
Baltimore, MD 21212-1010
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT004346WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Sep 1, 2025 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients
Fox Rehab PT MD LLC Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

1207 Liberty Rd
#106
Eldersburg, MD 21784
Phone (410) 549-5700

1207 Liberty Rd
Ste 106
Eldersburg, MD 21784
Phone (410) 549-5600

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

7819 Rocky Springs Rd
Frederick, MD 21702
Phone (301) 696-0808

9708 Belair Rd
Nottingham, MD 21236
Phone (410) 529-6911

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

470 N Lewis Rd
Limerick, PA 19468
Phone (610) 792-8800

1122 Highway 315 Blvd
Wilkes Barre, PA 18702
Phone (877) 407-4322

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1790392058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 DOWNS DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513308",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9708 Belair Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212361108",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9885 Greenbelt Rd",
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            "state": "MD",
            "postal_code": "207062302",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
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            "address_type": "DOM"
        },
        {
            "address_1": "1207 Liberty Rd # 106",
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            "postal_code": "217846574",
            "country_code": "US",
            "telephone_number": "410-549-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7819 Rocky Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217022824",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6451 N Charles St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212121010",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11665 Doolittle Dr",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206022898",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNBURG",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004346",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "9885 Greenbelt Rd",
            "city": "Lanham",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207062302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "6451 N Charles St",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212121010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3925 Downs Dr",
            "city": "Chantilly",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201513308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "9708 Belair Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212361108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7819 Rocky Springs Rd",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217022824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT MD LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "11665 Doolittle Dr",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206022898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/data-research/computer-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab OT CT, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "655 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064884220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "9885 Greenbelt Rd",
            "city": "Lanham",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207062302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.