Individual provider Active NPI

Timothy J Stiles, PT

  • Physical Therapist
  • Sheridan, WY
National Provider Identifier
1952301780
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2175 Issued in WY
Practice address
1981 Double Eagle Dr Ste a
Sheridan, WY 82801-2132
Phone
(307) 752-8354
Fax
(307) 466-1237
NPI assigned
Jul 22, 2005
Last updated
Feb 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-2175 WY Primary

Addresses

Primary practice location

1981 Double Eagle Dr Ste a
Sheridan, WY 82801-2132

Mailing address

1981 Double Eagle Dr Ste a
Sheridan, WY 82801-2132
Phone (307) 752-8354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220720003228 WY Practitioner - Physical Therapist in Private Practice 6608818240 Reassigns benefits to 1 organization
I20240820004114 NH Practitioner - Physical Therapist in Private Practice 6608818240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Univ of New England, College of Dental Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Belknap Occupational Health LLCGroup PAC ID 0648418558, 2 clinicians

Practice addresses (Care Compare)

614 Laconia Rd
Tilton, NH 03276-5322
Phone (603) 717-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5513NHMDClinical Social Worker
PT-2175WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Speech Therapy LLC CurrentSince Feb 12, 2023 Accepting new patients
One Hole Too Many LLC Physical Therapist CurrentSince Jul 11, 2022 Accepting new patients
Belknap Occupational Health LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Advanced Physical Therapy,LLC Physical Therapist Past Accepting new patients
Falmouth Physical Therapy Assoc Physical Therapist PastSince Jan 1, 1999 Accepting new patients
Back in Motion Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

614 Laconia Rd
Tilton, NH 03276
Phone (603) 717-7010

614 Laconia Rd
Unit 2
Tilton, NH 03276
Phone (603) 717-7010

1981 Double Eagle Dr
Ste A
Sheridan, WY 82801
Phone (307) 751-3076

800 Coffeen Ave
Ste B
Sheridan, WY 82801
Phone (307) 752-8354

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1952301780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 DOUBLE EAGLE DR STE A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012132",
            "telephone_number": "307-752-8354",
            "fax_number": "307-466-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 DOUBLE EAGLE DR STE A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012132",
            "telephone_number": "307-752-8354",
            "fax_number": "307-466-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-2175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.