Individual provider Active NPI

Elizabeth Tully-Nunn

  • Athletic Trainer
  • Hopkins, MN
National Provider Identifier
1912306051
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
1173 Issued in MN
Practice address
2000 Plymouth Rd
Suite 200
Hopkins, MN 55305-2366
Phone
(952) 545-0663
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1173 MN Primary

Addresses

Primary practice location

2000 Plymouth Rd
Suite 200
Hopkins, MN 55305-2366

Mailing address

2000 Plymouth Rd
Suite 200
Hopkins, MN 55305-2366
Phone (952) 545-0663

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

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1912306051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE 200",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "952-545-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE 200",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "952-545-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY-NUNN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkins, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.