Tyler Faulkner, LAT, ATC, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0001405 Issued in MD

Practice address

340 Magnolia Cir BLDG 1465
Tyndall Afb, FL 32403-5604

Phone

(850) 283-8298

NPI assigned

Sep 8, 2020

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

State licenses

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1609480631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR BLDG 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR BLDG 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "TYLER",
        "credential": "LAT, ATC, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0001405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Grace Dietrich, PHARM.D.
• Preston S Duffin, D.D.S, M.S.
• An Thuy Duong, MD
• Lori Elliott, DENTAL HYGIENIST
• Shauna M. Ezell, PHD, LCSW
• Zachary Flink, D.D.S.
• Timothy Gallagher, LCSW
• Mordecai Christopher Garcia
• Michelle Gautreaux, RDN/LDN
• Pamela Suzanne Gilley, LCSW

• Athletic Trainer in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.