Active NPI
Tyler John Brady, PT
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1801221452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14506
- Practice address
- 2400 W Mallard Creek Church Rd
Charlotte, NC 28262-2324 - Phone
- (704) 323-2000
- NPI assigned
- Sep 13, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 14506 | NC | Primary |
Addresses
Primary practice location
2400 W Mallard Creek Church Rd
Charlotte, NC 28262-2324
Mailing address
4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000
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 |
|---|---|---|---|
| 14506 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Activcare Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
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": "1379030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421193600000",
"number": "1801221452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD",
"address_2": "SUITE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093239",
"telephone_number": "704-323-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 W MALLARD CREEK CHURCH RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282622324",
"telephone_number": "704-323-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADY",
"first_name": "TYLER",
"middle_name": "JOHN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-13",
"last_updated": "2015-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "14506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.