Kyle A Vansickle, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1983 Issued in MN

Practice address

8100 W 78TH St Ste 225
Edina, MN 55439-2569

Phone

(952) 946-9777

NPI assigned

Jun 30, 2008

Last updated

Jun 30, 2008By the provider in NPPES

Sex

Male

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1447412606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083825",
            "telephone_number": "701-306-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 W 78TH ST STE 225",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392569",
            "telephone_number": "952-946-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSICKLE",
        "first_name": "KYLE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TSWV Feng Vang, MAT, LAT
• Christian Sommer Vankirk, M.D.
• Vincent R Vann Jr., MD, PHD
• Vannary Vanna, MPS, LPCC, LADC
• Joni Vanselow, PT
• Beth Vanwyngarden, L.A.C., MAOM
• Jeffrey Paul Vargo, M.D.
• Neeta Mody Vargo, MD
• James R Varholdt Jr., CNP
• Sucharita Varikuti, MBBS

• Athletic Trainer in Edina, MN
• Providers in Edina, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.