Individual provider Active NPI

Kyle Donald Traynor, D.C.

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1760712087
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5330 Issued in MN
Practice address
651 Nicollet Mall Ste 275
Minneapolis, MN 55402-1647
Phone
(612) 331-5757
NPI assigned
Jan 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5330 MN Primary

Addresses

Primary practice location

651 Nicollet Mall Ste 275
Minneapolis, MN 55402-1647

Mailing address

11995 Singletree LN Ste 120
Eden Prairie, MN 55344-5338
Phone (763) 220-6064

Other practice location 1

570 Bavaria Ln
Chaska, MN 55318-4597
Phone (612) 437-7674

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5330MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Perham Physical Therapy LTD. CurrentSince Apr 17, 2017 Accepting new patients
Chaska Lakes Chiropractic, PA Chiropractor PastSince Oct 19, 2014 Accepting new patients
Therapy Partners, Inc. PastSince Dec 15, 2019 Accepting new patients

Locations

3183 Northdale Blvd NW
Ste 103
Coon Rapids, MN 55433
Phone (763) 220-4844

11995 Singletree Ln
Ste 120
Eden Prairie, MN 55344
Phone (952) 373-5720

9325 Upland Ln N
Ste 230
Maple Grove, MN 55369
Phone (763) 242-3436

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1760712087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 120",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445338",
            "telephone_number": "763-220-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 NICOLLET MALL STE 275",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554021647",
            "telephone_number": "612-331-5757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Bavaria Ln",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553184597",
            "country_code": "US",
            "telephone_number": "612-437-7674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAYNOR",
        "first_name": "KYLE",
        "middle_name": "DONALD",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-08",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.