TYCHO E KERSTEN (NPI# 1568438562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568438562 |
| Entity Type | Individual |
| Full Name | TYCHO E KERSTEN |
| Credential | M.D. |
| Practice Address |
601 W 5th Ave Suite 400 Spokane WA 99204-2715 |
| Practice Telephone | 5093442663 |
| Practice Fax Number | 5096249179 |
| Mailing Telephone | 5093442663 |
| Mailing Fax Number | 5096249179 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2011-08-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
MD00039855 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806017400 | 05 | |
| WA | CRIME VICTIMS | 8928289 | 01 |
| WA | DEPT OF LABOR & INDUSTRIE | 0149631 | 01 |
| WA | 8276586 | 05 | |
| ID | REGENCE BLUE SHIELD | 000010135813 | 01 |
| WA | ASURIS NW HEALTH | 5030KE | 01 |
| WA | RR MEDICARE | 200040948 | 01 |
| WA | OWCP | 379109600 | 01 |
| WA | GROUP HEALTH NW | 22669 | 01 |
| ID | BLUE CROSS OF IDAHO | KQ803 | 01 |
| Street Address |
601 W 5TH AVE SUITE 400 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063414878 | Leann G Bach | Physician Assistant | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2715 | 2005-08-11 |
| 1851833669 | Jana Stuckrath | Nurse Practitioner | 601 W 5th Ave, Suite 301, Spokane, WA 99204-2705 | 2016-11-09 |
| 1497112320 | Inspire Physical Therapy Spokane Inc Ps | Physical Therapist | 601 W 5th Ave, Suite 308, Spokane, WA 99204-2705 | 2016-01-22 |
| 1790177822 | Allison Brighton Sayre | Nurse Practitioner | 601 W 5th Ave, Suite 301, Spokane, WA 99204-2705 | 2015-02-26 |
| 1639572985 | Anthony O'neel | Physician Assistant | 601 W 5th Ave, Spokane, WA 99204-2705 | 2014-10-01 |
| 1932513900 | David Allen Baca | Physician Assistant | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2705 | 2014-06-17 |
| 1518393396 | Sally Delger | Nurse Practitioner | 601 W 5th Ave, Suite 301, Spokane, WA 99204-2705 | 2013-09-24 |
| 1699050575 | Brieanne Catherine Gray | Nurse Practitioner | 601 W 5th Ave, Suite #301, Spokane, WA 99204-2714 | 2011-10-11 |
| 1407181019 | Mark Jerome Buescher | Physician Assistant | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2705 | 2009-10-15 |
| 1235327933 | Northwest Orthopaedic Specialists | Orthopaedic Surgery | 601 W 5th Ave, Suite 400, Spokane, WA 99204-2175 | 2007-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194822874 | Amaryllis J. Scott | Orthopaedic Surgery | 785 E Holland Ave, Spokane, WA 99218-1257 | 2006-09-17 |
| 1205887056 | Christopher George Anderson | Orthopaedic Surgery | 12410 East Sinto, Suite 210, Spokane, WA 99216 | 2006-05-15 |
| 1497902340 | Jared John Allred | Orthopaedic Surgery | 400 E 5th Ave, Spokane, WA 99202-1334 | 2008-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972073799 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 150 Andover Park W, Tukwila, WA 98188-2801 | 2018-12-05 |
| 1376751669 | Christopher J. Van Hofwegen | Orthopaedic Surgery | 2979 Squalicum Pkwy Ste 203, Bellingham, WA 98225-1813 | 2007-05-18 |
| 1477572931 | James J Wyman | Orthopaedic Surgery | 11212 Sunrise Blvd E Ste 201, Puyallup, WA 98374-8847 | 2006-07-18 |
| 1295774016 | Public Hospital Dist No 1 Skagit | Orthopaedic Surgery | 328 S. Stillaguamish Ave., Arlington, WA 98223-1660 | 2006-06-06 |
| 1942250535 | Vincent M Santoro | Orthopaedic Surgery | 12333 Ne 130th Lane, #400, Kirkland, WA 98034-7467 | 2006-05-12 |
| 1720040371 | Phillip A Medina | Orthopaedic Surgery | 4361 Talbot Road S, #102, Renton, WA 98055 | 2006-04-06 |
| 1356326870 | Donald William Henline | Orthopaedic Surgery | 3726 Broadway Ste 201, Everett, WA 98201-3788 | 2005-12-07 |
| 1679122758 | Taylor Nicole Fowers | Orthopaedic Surgery | 12039 Ne 128th St Ste 400, Kirkland, WA 98034-3029 | 2019-09-10 |
| 1952831083 | Kyle Hazelwood Md Pllc | Orthopaedic Surgery | 825 Se Bishop Blvd Ste 120, Pullman, WA 99163-5517 | 2017-06-12 |
| 1306186275 | Bruce C Twaddle | Orthopaedic Surgery | 3800 Montlake Blvd, Room 148b, Seattle, WA 98195-0007 | 2013-02-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.