Active NPI
Tyler William Fleck, ATC
- Athletic Trainer
- Mechanicsburg, PA
National Provider Identifier
1598133597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 77 Clouser Rd
Mechanicsburg, PA 17055-9743 - Phone
- (717) 697-5015
- NPI assigned
- Sep 8, 2015
- Last updated
- Sep 8, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
77 Clouser Rd
Mechanicsburg, PA 17055-9743
Mailing address
77 Clouser Rd
Mechanicsburg, PA 17055-9743
Phone (717) 697-5015
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000022549 | Other | BOARD OF CERTIFICATION-ATHLETIC TRAINER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1598133597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 CLOUSER RD",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170559743",
"telephone_number": "717-697-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 CLOUSER RD",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170559743",
"telephone_number": "717-697-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLECK",
"first_name": "TYLER",
"middle_name": "WILLIAM",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-08",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION-ATHLETIC TRAINER",
"identifier": "2000022549",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mechanicsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.