Tyler Corcoran, MS, LAT, ATC, ITAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT002548 Issued in GA

Practice address

3737 Brock Rd
Duluth, GA 30096-2724

Phone

(706) 910-9834

NPI assigned

Sep 29, 2015

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1467822833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1362 WOODLAND VIEW RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437512",
            "telephone_number": "706-910-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 BROCK RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300962724",
            "telephone_number": "706-910-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "TYLER",
        "credential": "MS, LAT, ATC, ITAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-29",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Duluth, GA
• Providers in Duluth, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.