Active NPI
Timothy L Lyles Jr., OTR/L
- Occupational Therapist
- Anderson, IN
National Provider Identifier
1942760061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31006851A
- Practice address
- 1118 W Cross St
Anderson, IN 46011-9530 - Phone
- (765) 274-4464
- NPI assigned
- Mar 24, 2019
- 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 | 31006851A | IN | Primary |
Addresses
Primary practice location
1118 W Cross St
Anderson, IN 46011-9530
Mailing address
105 N Hudson St
Sheridan, IN 46069-1133
Phone (240) 357-6612
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 |
|---|---|---|---|
| 31006851A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553385600000",
"number": "1942760061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N HUDSON ST",
"city": "SHERIDAN",
"state": "IN",
"postal_code": "460691133",
"telephone_number": "240-357-6612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 W CROSS ST",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460119530",
"telephone_number": "765-274-4464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYLES",
"first_name": "TIMOTHY",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-24",
"last_updated": "2019-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31006851A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.