Ethan Worth Lyle, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

2305216451 Issued in VA

Practice address

457 McLaws Cir Ste a
Williamsburg, VA 23185-5645

Phone

(757) 271-4447

Fax

(847) 886-4172

NPI assigned

Feb 22, 2025

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

Practice roles

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.

• Fleming Therapy Services, LLC

  • Speech-Language Pathologist
  • Stafford, VA
  • NPI 1194925818
  NPD (past)

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

{
    "created_epoch": "1740182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740182400000",
    "number": "1861298549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 MCLAWS CIR STE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855645",
            "telephone_number": "757-271-4447",
            "fax_number": "847-886-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 MCLAWS CIR STE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855645",
            "telephone_number": "757-271-4447",
            "fax_number": "847-886-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLE",
        "first_name": "ETHAN",
        "middle_name": "WORTH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-22",
        "last_updated": "2025-02-22",
        "certification_date": "2025-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "VA",
            "license": "2305216451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Ann Lutz, PHARMACIST
• Luxottica of America Inc.
• Lwell LLC
• Lwell LLC
• Amber Nichole Lykins, FNP
• Jody B Lyle, CRNA
• John Shaw Lynch, MPAS PA-C
• Lynn Lynes, LCSW
• Dana M Lyon, L.P.C.
• Cliff Machoka, PHARM D.

• Pediatric Physical Therapist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Pediatric Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2025; 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.