Tyan Kan

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13373 Issued in MN

Practice address

6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356

Phone

(612) 364-1901

NPI assigned

Aug 25, 2020

Last updated

May 13, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Odom Sports Medicine PAGroup PAC ID 0143485607, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Odom Sports Medicine, P.a.

  dba Odom Health & Wellness

  • Sports Medicine (Family Medicine) Physician
  • Eden Prairie, MN
  • NPI 1275557886
  Medicare reassignment Care Compare group NPD
• Active Physical Therapy Services, LLC

  • Physical Therapist
  • Laurel, MD
  • NPI 1225217334
  NPD
• Sage Physical Therapy & Wellness LLC

  dba Advanced Physical Therapy

  • Physical Therapy Clinic/Center
  • Cambridge, MD
  • NPI 1467757575

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1265045793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419666",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419666",
            "telephone_number": "410-970-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FLYING CLOUD DR STE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443356",
            "telephone_number": "612-364-1901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "497 Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Prince Frederick",
            "state": "MD",
            "postal_code": "206783190",
            "country_code": "US",
            "telephone_number": "410-414-3560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3311 Toledo Ter Ste A1",
            "address_purpose": "LOCATION",
            "city": "Hyattsville",
            "state": "MD",
            "postal_code": "207824136",
            "country_code": "US",
            "telephone_number": "301-853-0093",
            "fax_number": "301-853-0096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9135 Piscataway Rd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MD",
            "postal_code": "207352554",
            "country_code": "US",
            "telephone_number": "410-877-2323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAN",
        "first_name": "TYAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27814",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Steven Kaehr, BA
• Dean A Kaihoi, M.D.
• Kendra Kajer, DC
• Paul E Kaldor, M.D.
• Christina Kaluza, M.S., CCC-SLP
• Jon P Kane, M.D.
• Shelly Ann Kang
• Anthony M Kangea
• Wayne R Kaniewski, M.D.
• Sharon E. Kanters, M.A.

• Physical Therapist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.