Individual provider Active NPI

Elizabeth Halstead Tyler, PT, DPT

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1962142083
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214864 Issued in VA
Practice address
9980 Brook Rd Unit 16
Glen Allen, VA 23059-6501
Phone
(919) 258-2714
Fax
(410) 648-4878
NPI assigned
Mar 29, 2022
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 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 2305214864 VA Primary

Addresses

Primary practice location

9980 Brook Rd Unit 16
Glen Allen, VA 23059-6501

Mailing address

3124 Blithewood Drive
Richmond, VA 23225
Phone (757) 814-5636

Other names 1

  • Elizabeth Tyler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220504001326 VA Practitioner - Physical Therapist in Private Practice 0345637740 Reassigns benefits to 2 organizations
I20230727000893 DC Practitioner - Physical Therapist in Private Practice 0345637740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9980 Brook Rd Unit
Suite 16
Glen Allen, VA 23059-6501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients

Locations

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

7 Carnegie Plz
Cherry Hill, NJ 08003

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

9980 Brook Rd
Unit 16
Glen Allen, VA 23059
Phone (804) 550-5730

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

20 E Piccadilly St
Ste 1114
Winchester, VA 22601

Organizations & group practices 3

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1962142083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 BLITHEWOOD DRIVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23225",
            "telephone_number": "757-814-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 BROOK RD UNIT 16",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230596501",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "ELIZABETH",
        "middle_name": "HALSTEAD",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-07-05",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "TYLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.