Active NPI
Tyler Guckeen
- Athletic Trainer
- Brooklyn Park, MN
National Provider Identifier
1962225128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 6001 96TH LN N Ste 200
Brooklyn Park, MN 55445-4606 - Phone
- (763) 373-0400
- NPI assigned
- Nov 6, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
6001 96TH LN N Ste 200
Brooklyn Park, MN 55445-4606
Mailing address
2021 128TH Ave NW
Coon Rapids, MN 55448-7008
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": "1730851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1962225128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2021 128TH AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554487008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 96TH LN N STE 200",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554454606",
"telephone_number": "763-373-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUCKEEN",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-06",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.