Active NPI
Tyler Craun
- Physical Therapist
- Port Orange, FL
National Provider Identifier
1962037754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5535 S Williamson Blvd Ste 705
Port Orange, FL 32128-8311 - Phone
- (386) 231-6327
- NPI assigned
- Mar 11, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
5535 S Williamson Blvd Ste 705
Port Orange, FL 32128-8311
Mailing address
1717 Savannah LN
Port Orange, FL 32128-7509
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1962037754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 SAVANNAH LN",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321287509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5535 S WILLIAMSON BLVD STE 705",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321288311",
"telephone_number": "386-231-6327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAUN",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-11",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.