Kevyn Ayn Funk, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2686 Issued in MN

Practice address

1710 Suburban Ave
Saint Paul, MN 55106-6636

Phone

(651) 254-3200

NPI assigned

Feb 15, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1013772367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 44TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062904",
            "telephone_number": "775-324-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 SUBURBAN AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066636",
            "telephone_number": "651-254-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "KEVYN",
        "middle_name": "AYN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Fuller, LAMFT
• Lauren Fullerton, M.A., LADC
• Susan Patricia Fullerton, LPCC
• William Fullerton
• David Robert Fulton, PT
• Linda M. Funk, M.D.
• Lauren Clare Funke
• Kayla C Fuqua, CO
• Ariana Isis Furlong
• Clark Michael Furlong, PA-C

• Physical Therapy Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.