Individual provider Active NPI

Lanning Tucker, ATC, LAT, ATR

  • Athletic Trainer
  • Minneapolis, MN
National Provider Identifier
1194145755
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2549 Issued in MN
Practice address
1 Twins Way
Minneapolis, MN 55403-1418
Phone
(612) 659-3694
Fax
(612) 659-4035
NPI assigned
Apr 22, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2549 MN Primary
Athletic Trainer 2255A2300X AT1030 TX
Athletic Trainer 2255A2300X AL358 FL

Addresses

Primary practice location

1 Twins Way
Minneapolis, MN 55403-1418

Mailing address

1 Twins Way
Minneapolis, MN 55403-1418
Phone (612) 659-3694

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

State licenses

LicenseStateTypeSpecialty
AL358FLMDAthletic Trainer
AT1030TXMDAthletic Trainer
2549MNMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1194145755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TWINS WAY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554031418",
            "telephone_number": "612-659-3694",
            "fax_number": "612-659-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TWINS WAY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554031418",
            "telephone_number": "612-659-3694",
            "fax_number": "612-659-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "LANNING",
        "credential": "ATC, LAT, ATR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2549",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT1030",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.