Tyler Dickenson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5143 Issued in AR

Practice address

3307 N Dixieland Rd
Rogers, AR 72756-6816

Phone

(479) 986-5150

Fax

(479) 986-5191

NPI assigned

Aug 15, 2022

Sex

Male

Sole proprietor

Yes

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.

• Kids for the Future of Western Benton County, LLC

  • Developmental Disabilities Clinic/Center
  • Decatur, AR
  • NPI 1306591201
  NPD (past)
• Kids for the Future Rogers, Inc.

  • Developmental Disabilities Clinic/Center
  • Rogers, AR
  • NPI 1508037870
  NPD (past)
• Kidscorp of Fayetteville, Inc

  • Developmental Disabilities Clinic/Center
  • Springdale, AR
  • NPI 1790124659
  NPD (past)

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1902524176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727570130",
            "telephone_number": "479-986-5150",
            "fax_number": "479-986-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 N DIXIELAND RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727566816",
            "telephone_number": "479-986-5150",
            "fax_number": "479-986-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 Main Dr",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727626802",
            "country_code": "US",
            "telephone_number": "479-856-6397",
            "fax_number": "479-856-6412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 S Main St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AR",
            "postal_code": "727229799",
            "country_code": "US",
            "telephone_number": "479-212-5030",
            "fax_number": "479-212-5029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKENSON",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT5143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shari Malini Desilva, MD
• Devin Moore Chiropractic PLLC
• Diamond Therapy Partners, LLC
• Rene E Diamond, DO
• Alyssa J Diaz
• Patrick Callen Dickerson, M.D.
• Robert Wasson Dickey, PT
• Marleigh Dietz, PHARMD
• Tori Dilbeck
• Taylor Alexis Dillon, M.S., CF-SLP

• Physical Therapist in Rogers, AR
• Providers in Rogers, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.