TLC of the Twin Cities

Primary specialty

OptometristTaxonomy code 152W00000X

License

2527 Issued in MN

Legal business name

TLC OF THE TWIN CITIES

Practice address

13020 Riverdale Dr NW
Coon Rapids, MN 55448-1057

Phone

(763) 421-9562

Fax

(763) 421-9564

NPI assigned

May 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tracy Lynn Christensen, O.D.NPI 1568523843

Title

Ceo

Phone

(763) 420-4026

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Tax ID family

TLC of the Twin Cities2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• TLC of the Twin Cities

  • Optometrist
  • Maple Grove, MN
  • NPI 1053504779
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy Christensen, OD

  • Optometrist
  • Maple Grove, MN
  • NPI 1568523843
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1699981738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16555 77TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113734",
            "telephone_number": "763-420-4026",
            "fax_number": "763-420-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 RIVERDALE DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554481057",
            "telephone_number": "763-421-9562",
            "fax_number": "763-421-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC OF THE TWIN CITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-420-4026",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "334M3WA  334M4CH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "2202630",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "297601016602",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Lynn Thurner
• Michael D Thyen, CRNA
• Taylor Elizabeth Tiedemann
• Tillges Certified Orthotic Prosthetic, Inc.
• Kelli Timinski, CCC-SLP
• Robert William Tofte, MD
• Jennica Tomassoni, PSY.D LP
• Robin Marie Tomczak
• Naomi Torgerson
• Ryan Torgrude, PT

• Optometrist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.