Kala M Frederiksen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

077175 Issued in IA

Practice address

42369 Crestview Cir
Northville, MI 48168-3266

Phone

(515) 231-7057

NPI assigned

Jun 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kala Plantz Former name

Medicare fee-for-service enrollment

Enrolled in IA, MI2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Protera Health Medical Group, P.C.

  • Orthopaedic Surgery Physician
  • Troy, MI
  • NPI 1649059742

  Physical Therapist

  Medicare reassignment NPD
• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166

  IA

  Medicare reassignment NPD
• Northville Physical Rehabilitation, P.C.

  • Physical Therapist
  • Northville, MI
  • NPI 1982770673
  NPD
• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490

  Physical Therapist

  NPD

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1053606657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42369 CRESTVIEW CIR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481683266",
            "telephone_number": "515-231-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42369 CRESTVIEW CIR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481683266",
            "telephone_number": "515-231-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKSEN",
        "first_name": "KALA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11819-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "077175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053606657",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALA",
            "last_name": "PLANTZ",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Florance, PHARMD
• Stacie Lee Ford, D.C.
• Tucker Eugene Ford, D.C.
• Frank Sun DDS PC
• John Bernard Frasik
• Barbara Sue Freeland, RN
• Connie S Freeman, OTR
• Amy Freij, RD
• Steven T. Fried, M.D.
• Ashley Friedrichs

• Physical Therapist in Northville, MI
• Providers in Northville, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.