Active NPI
Tyler Daniel Phillips, OTD
- Occupational Therapist
- Omaha, NE
National Provider Identifier
1871937649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1712
- Practice address
- 11623 Arbor St
Omaha, NE 68144-2981 - Phone
- (402) 334-1919
- Fax
- (402) 334-6844
- NPI assigned
- Apr 24, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1712 | NE | Primary |
Addresses
Primary practice location
11623 Arbor St
Omaha, NE 68144-2981
Mailing address
1808 Ridgeview Dr
Papillion, NE 68046-8238
Phone (402) 416-6891
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 |
|---|---|---|---|
| 1712 | NE | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366761600000",
"number": "1871937649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 RIDGEVIEW DR",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680468238",
"telephone_number": "402-416-6891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11623 ARBOR ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442981",
"telephone_number": "402-334-1919",
"fax_number": "402-334-6844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TYLER",
"middle_name": "DANIEL",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-24",
"last_updated": "2013-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.