TLC of the Twin Cities

Primary specialty

OptometristTaxonomy code 152W00000X

License

2527 Issued in MN

Legal business name

TLC OF THE TWIN CITIES

Practice address

11330 Fountains Dr
Maple Grove, MN 55369-7200

Phone

(763) 494-8061

NPI assigned

Aug 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tracy Lynn ChristensenNPI 1568523843

Title

Ceo

Phone

(763) 420-4026

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

TLC of the Twin Cities2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• TLC of the Twin Cities

  • Optometrist
  • Coon Rapids, MN
  • NPI 1699981738
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Christensen, OD

  • Optometrist
  • Maple Grove, MN
  • NPI 1568523843
  NPD (past) Authorized official

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1053504779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16555 77TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113734",
            "telephone_number": "763-420-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 FOUNTAINS DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697200",
            "telephone_number": "763-494-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC OF THE TWIN CITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-420-4026",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "334M3WA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2202630",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREF ONE",
            "identifier": "297601016602",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U59524",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent Edwin Tieri, D.C.
• Kimberly S Tiesma
• Sarah Kathleen Tillman, MD
• Katherine Marie Timcho, WHNP
• Timothy J Maher D P M P a
• Milos Tomaides, D.D.S.
• Shaeleigh Caroline Tomlinson
• Katherine Ellen Tilton Tomscha, PA-C
• Richard William Topel, DDS
• Brian Traeger, PA-C

• Optometrist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.