Active NPI
Tylea Bergman
- Physical Therapist
- Piedmont, SD
National Provider Identifier
1942789425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2234
- Practice address
- 21698 Piedmont Meadows Rd
Piedmont, SD 57769-7114 - Phone
- (605) 390-4326
- NPI assigned
- Aug 7, 2018
- Last updated
- Dec 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2199 | ND | |
| Physical Therapist | 225100000X | 2234 | SD | Primary |
Addresses
Primary practice location
21698 Piedmont Meadows Rd
Piedmont, SD 57769-7114
Mailing address
21698 Piedmont Meadows Rd
Piedmont, SD 57769-7114
Phone (605) 390-4326
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2199 | ND | MD | Physical Therapist |
| 2234 | SD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omaha Therapy, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Countryside Physical Therapy
- Physical Therapy Clinic/Center
- Killdeer, ND
- NPI 1487127825
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1942789425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21698 PIEDMONT MEADOWS RD",
"city": "PIEDMONT",
"state": "SD",
"postal_code": "577697114",
"telephone_number": "605-390-4326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21698 PIEDMONT MEADOWS RD",
"city": "PIEDMONT",
"state": "SD",
"postal_code": "577697114",
"telephone_number": "605-390-4326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGMAN",
"first_name": "TYLEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-07",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "2199",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "2234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Piedmont, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.