Tyler Lee Jamison, ATC

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

AT662 Issued in ME

Practice address

925 Union St Ste 3
Bangor, ME 04401-3051

Phone

(207) 974-7400

NPI assigned

Nov 14, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1831668342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CHARLES ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014651",
            "telephone_number": "207-592-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 UNION ST STE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013051",
            "telephone_number": "207-974-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "TYLER",
        "middle_name": "LEE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "ME",
            "license": "AT662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane A James, FNP
• Lauren James, AUD
• Theodore William James, M.D.
• Mitchell Anthony Jameson
• Thomas Bros Jamieson, LAC.
• Emma Martina Jandreau
• Jesse Jandreau, PT, DPT
• Vessa Jandreau, LCPC, CADC, CCS
• Alan Jansujwicz, M.D.
• Joshua Kaufmann Jantzi, MD

• Pediatric Sports Medicine Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Pediatric Sports Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.