Tyler Campbell Rasberry, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.4110 Issued in SC

Practice address

157 Home Ave
Darlington, SC 29532-7625

Phone

(843) 393-2867

NPI assigned

Dec 5, 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": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1861963647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 WILLOW CREEK RD",
            "city": "EFFINGHAM",
            "state": "SC",
            "postal_code": "295413631",
            "telephone_number": "843-468-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 HOME AVE",
            "city": "DARLINGTON",
            "state": "SC",
            "postal_code": "295327625",
            "telephone_number": "843-393-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASBERRY",
        "first_name": "TYLER",
        "middle_name": "CAMPBELL",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "PTA.4110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Austin Perry, DMD
• Pilot Club of Darlington Foundation Inc.
• Keith Charles Player, MD
• Victoria Poole
• Pure Serenity Consultant and Counseling Services, LLC
• RB Express LLC
• Chassidy Elizabeth Rettell, PTA
• Amber Holloway Rodgers
• Jessica Rohletter, COTA/L
• Rural Health Providers LLC

• Physical Therapy Assistant in Darlington, SC
• Providers in Darlington, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.