Individual provider Active NPI

Dylan Blaylock, DPT

  • Physical Therapist
  • Beckley, WV
National Provider Identifier
1790623536
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT004922 Issued in WV
Practice address
9 Yellow Wood Way
Beckley, WV 25801-7126
Phone
(304) 255-2376
Fax
(304) 255-7120
NPI assigned
Mar 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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 PT004922 WV Primary

Addresses

Primary practice location

9 Yellow Wood Way
Beckley, WV 25801-7126

Mailing address

PO Box 932184
Atlanta, GA 31193-2184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331002325 WV Practitioner - Physical Therapist in Private Practice 5193200897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 31193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT004922WVMDPhysical Therapist

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": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1790623536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 YELLOW WOOD WAY",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258017126",
            "telephone_number": "304-255-2376",
            "fax_number": "304-255-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "DYLAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.