Tyler Anthony Bader

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

AT005827 Issued in OH

Practice address

4403 Far Hills Ave
Kettering, OH 45429-2405

Phone

(937) 395-3900

NPI assigned

Aug 22, 2019

Last updated

Aug 22, 2019By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tyler.bader@ketteringhealth.org

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1922655174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N MAIN AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453652152",
            "telephone_number": "859-468-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 FAR HILLS AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292405",
            "telephone_number": "937-395-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "TYLER",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OH",
            "license": "AT005827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.bader@ketteringhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4403 Far Hills Ave",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454292405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rajpal Aujla, MD
• Randall I Aybar, M.D.
• Ryan Matthew Babienco, M.D.
• Catherine Dutton Bacheller, M.D.
• Christine Back, MS, CCC-SLP
• Janet M Baedke, CRNA
• Connie Sue Bain, P.T.
• Carrie Baker, D.O.
• Crystal Charlene Baker
• Jennifer Baker, MSW, LISW-S

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.