Individual provider Active NPI

Tanner Collin Kuketz, EP

  • Clinical Exercise Physiologist
  • Tempe, AZ
National Provider Identifier
1396659868
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
License
2000017 Issued in FL
Practice address
2223 S 48TH St Ste H
Tempe, AZ 85282-1011
Phone
(863) 338-0993
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X 2000017 FL Primary

Addresses

Primary practice location

2223 S 48TH St Ste H
Tempe, AZ 85282-1011

Mailing address

800 E Curry Rd Apt 3021
Tempe, AZ 85288-7057
Phone (863) 338-0993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1396659868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E CURRY RD APT 3021",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852887057",
            "telephone_number": "863-338-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 S 48TH ST STE H",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821011",
            "telephone_number": "863-338-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUKETZ",
        "first_name": "TANNER",
        "middle_name": "COLLIN",
        "credential": "EP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "FL",
            "license": "2000017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.