Active NPI
Tyler B Young, DPT
- Physical Therapist
- Morrow, GA
National Provider Identifier
1851687669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT010272
- Practice address
- 1368 Southlake Plaza Dr
Morrow, GA 30260-1756 - Phone
- (678) 422-8824
- NPI assigned
- Jun 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | PT010272 | GA | Primary |
Addresses
Primary practice location
1368 Southlake Plaza Dr
Morrow, GA 30260-1756
Mailing address
437 Patterson Ave
Scottdale, GA 30079-1133
Phone (717) 413-2959
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT010272 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1851687669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "437 PATTERSON AVE",
"city": "SCOTTDALE",
"state": "GA",
"postal_code": "300791133",
"telephone_number": "717-413-2959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1368 SOUTHLAKE PLAZA DR",
"city": "MORROW",
"state": "GA",
"postal_code": "302601756",
"telephone_number": "678-422-8824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "TYLER",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-21",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT010272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrow, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.