Active NPI
Maxwell Taylor Cerny
- Athletic Trainer
- Saint Cloud, MN
National Provider Identifier
1639687957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 3070
- Practice address
- 1120 9TH Ave S Apt 103
Saint Cloud, MN 56301-5566 - Phone
- (608) 769-5252
- NPI assigned
- Jan 22, 2018
- 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 | 3070 | MN | Primary |
Addresses
Primary practice location
1120 9TH Ave S Apt 103
Saint Cloud, MN 56301-5566
Mailing address
1120 9TH Ave S Apt 103
Saint Cloud, MN 56301-5566
Phone (608) 769-5252
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 |
|---|---|---|---|
| 3070 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516579200000",
"number": "1639687957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 9TH AVE S APT 103",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563015566",
"telephone_number": "608-769-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 9TH AVE S APT 103",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563015566",
"telephone_number": "608-769-5252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERNY",
"first_name": "MAXWELL",
"middle_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-22",
"last_updated": "2018-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "3070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
- Central Minnesota Orthodontics
- Central Minnesota Solutions
- Central MN Pediatric Dentists PA
- Centrasota Eye Care, Inc (Centrasota Eye Care & Laser Surgery)
- Centrasota Oral & Maxillofacial Surgeons, P.a.
- Kristine M Cervin, PHARMD
- Lily Faith Chamerski
- Richard J Chandler, RPP, CA, LMT
- Anil Kumar Changarath Vijayan, MBBS
- Melissa A Chapman, PAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.