Tanner Kimber, ATC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

2000017447 Issued in MN

Practice address

8100 Northland Dr
Bloomington, MN 55431-4800

Phone

(952) 806-5693

NPI assigned

Sep 18, 2014

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": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1629470992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10523 FIRST TIMBERLANE DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550574466",
            "telephone_number": "952-201-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 NORTHLAND DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314800",
            "telephone_number": "952-806-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBER",
        "first_name": "TANNER",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "MN",
            "license": "2000017447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miski Khayre
• Brenda Kiberu-Kalema
• Thomas A Kiefer, M.D.
• Rachel Marie Kierski, PA-C
• Taehwan Kim, M.D.
• Jason B Kimmel, PAC
• Randy Kimpell, MD
• Ramnon F Kinfu
• Angelique Khaliah King
• Colin King, M.D.

• Sports Medicine (Emergency Medicine) Physician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Sports Medicine (Emergency Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.