Tys Cranial Prothesis

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

TYS CRANIAL PROTHESIS

Practice address

2400 S Memorial Dr Ste 3B
Greenville, NC 27834-5031

Phone

(252) 814-7136

Fax

(252) 302-4975

NPI assigned

Sep 21, 2020

Last updated

Sep 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tijaquania Gardner

Title

Owner

Phone

(252) 814-7136

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1891301156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S MEMORIAL DR STE 3B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345031",
            "telephone_number": "252-814-7136",
            "fax_number": "252-302-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S MEMORIAL DR STE 3B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345031",
            "telephone_number": "252-814-7136",
            "fax_number": "252-302-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYS CRANIAL PROTHESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "TIJAQUANIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-814-7136"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "2523024975",
            "affiliation": "N",
            "endpointDescription": "Fax#",
            "address_1": "2400 S Memorial Dr Ste 3B",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278345031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peyton Twiddy
• Sharon Denise Tyer, MS, CRC, LPCA
• Shannon A Tyler, MD
• Lisa Tyndall, PH.D
• William Greg Tyner, PTA
• Anna Tyson, OTR/L
• Danielle Tyson
• Lamont Tyson
• Liliane Ziherambere Tyson, MD
• U Shine Community Outreach Inc, Youth Expressing Lifestyle Passions

• Prosthetic/Orthotic Supplier in Greenville, NC
• Providers in Greenville, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.