Tyler G Wilson, DPT, OMPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501015894 Issued in MI

Practice address

2380 Cedar St Ste 203
Holt, MI 48842-2211

Phone

(517) 409-4677

Fax

(517) 798-5667

NPI assigned

May 16, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier RehabilitationGroup PAC ID 5698094795, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Premier Rehabilitation

  • Physical Therapist
  • Holt, MI
  • NPI 1306244066
  Medicare reassignment Care Compare group NPD Authorized official
• Orthopaedic Rehab Specialists, PC

  • Physical Therapist
  • Jackson, MI
  • NPI 1619956646
  NPD (past)

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831458413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 CEDAR ST STE 203",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422211",
            "telephone_number": "517-409-4677",
            "fax_number": "517-798-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 CEDAR ST STE 203",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488422211",
            "telephone_number": "517-409-4677",
            "fax_number": "517-798-5667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 N. Aurelius",
            "address_purpose": "LOCATION",
            "city": "Holt",
            "state": "MI",
            "postal_code": "488421367",
            "country_code": "US",
            "telephone_number": "517-783-6670",
            "fax_number": "517-783-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TYLER",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "DPT, OMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellyse Marie Weigelt
• Lauren Weikel, ATC
• Timothy T Wellemeyer, MD
• Sally Ann Wesseldyk
• Dana Joseph William
• Meghan K Wise, RDN
• Woodward Detroit CVS, L.L.C.
• Grace Anne Wright
• Didiana Yingxia Zeng

• Physical Therapist in Holt, MI
• Providers in Holt, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.