Alyssa Rose Taylor

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000033575 Issued in MN

Practice address

2104 Northdale Blvd NW Ste 100
Coon Rapids, MN 55433

Phone

(763) 755-5495

NPI assigned

Jan 25, 2018

Last updated

Jul 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1205334190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20540 GEORGIA AVE N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550258009",
            "telephone_number": "612-558-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "763-755-5495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Bethel Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551126902",
            "country_code": "US",
            "telephone_number": "612-558-7932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ALYSSA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2000033575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Tanner
• Tany Logistics Group LLC
• Jillian Tanych, DPT
• Megan Kathleen Tappe
• Phurbu Tara, CNP
• Ashlee Ann Taylor, PA-C
• Kyalie Taylor
• Lastara Taylor
• Molly Teigen, PA-C
• Louis Fomum Tekock

• Athletic Trainer in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.