Active NPI
Ian Roderick Macpherson, ATC, LAT
- Athletic Trainer
- Golden Valley, MN
National Provider Identifier
1629612072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 3160
- Practice address
- 4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841 - Phone
- (952) 512-5625
- NPI assigned
- Oct 29, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 3160 | MN | Primary |
Addresses
Primary practice location
4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Mailing address
937 Cromwell Ave
Saint Paul, MN 55114-1121
Phone (651) 890-2342
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3160 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1629612072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 CROMWELL AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141121",
"telephone_number": "651-890-2342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 DAHLBERG DR STE 300",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224841",
"telephone_number": "952-512-5625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACPHERSON",
"first_name": "IAN",
"middle_name": "RODERICK",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-29",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "3160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.