Tyler Michael Knutson, DC, CSCS

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6472 Issued in MN

Practice address

1421 E Wayzata Blvd
Wayzata, MN 55391

Phone

(952) 473-9637

Fax

(952) 473-1851

NPI assigned

Apr 25, 2018

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

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2017

Medicare assignment

May accept Medicare assignment

Group practices

The Brost Clinic, PAGroup PAC ID 8527049956, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Brost Clinic, PA

  • Chiropractor
  • Wayzata, MN
  • NPI 1407028939

  MN

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1467940478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10973 104TH PL N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692826",
            "telephone_number": "763-567-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E WAYZATA BLVD",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-473-9637",
            "fax_number": "952-473-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "TYLER",
        "middle_name": "MICHAEL",
        "credential": "DC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Margaret Kane, P.T.
• Rebecca M Kastner, PHD, LP, ABPP
• Meghan Gearity Kimmel
• Bria Kirkpatrick
• Annika Knutson
• William Howard Koch II, P.T.
• Dawn Julia Koehler, PSY.D.
• Emily Kos, ND
• Jedidiah F. Krauss, D.C.
• Josh Kruize

• Chiropractor in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.