Individual provider Active NPI

Tyler Michael Mobley, P.T.

  • Physical Therapist
  • Anniston, AL
National Provider Identifier
1881748408
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2072 Issued in AL
Practice address
400 E 10TH St
Anniston, AL 36207-4716
Phone
(256) 235-5860
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2072 AL Primary

Addresses

Primary practice location

400 E 10TH St
Anniston, AL 36207-4716

Mailing address

PO Box 1380
Anniston, AL 36202-1380
Phone (256) 235-5860

Other practice location 1

1622 Church Ave SE
Jacksonville, AL 36265-3200
Phone (256) 365-2792

Other identifiers 1

IdentifierTypeStateIssuer
98783OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000013 AL Practitioner - Physical Therapist in Private Practice 7214007053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of South Alabama College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2215 Decatur Hwy
Suite 125
Gardendale, AL 35071-2385
Phone (205) 285-8790

800 Pelham Rd S
Jacksonville, AL 36265-2736
Phone (256) 365-2792

886 US Hwy 431
Boaz, AL 35957-1925
Phone (256) 803-2178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2072ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy-Alabama, LLC Physical Therapist CurrentSince Mar 27, 2023 Accepting new patients
Drayer Physical Therapy Alabama LLC CurrentSince Mar 27, 2023 Accepting new patients
Champion Rehab Resources, LLC Physical Therapist PastSince Mar 25, 2026 Accepting new patients

Locations

2215 Decatur Hwy
Ste 125
Gardendale, AL 35071
Phone (205) 285-8790

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1622 Church Ave SE
Jacksonville, AL 36265
Phone (256) 365-2792

800 Pelham Rd S
Jacksonville, AL 36265
Phone (256) 365-2792

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1881748408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1380",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362021380",
            "telephone_number": "256-235-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 10TH ST",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362074716",
            "telephone_number": "256-235-5860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1622 Church Ave SE",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "AL",
            "postal_code": "362653200",
            "country_code": "US",
            "telephone_number": "256-365-2792",
            "fax_number": "256-365-2793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "TYLER",
        "middle_name": "MICHAEL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "2072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "98783",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.