Individual provider Active NPI

Kaysie Hendrickson, DPT

  • Physical Therapist
  • Edina, MN
National Provider Identifier
1205029493
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7987 Issued in MN
Practice address
8100 W 78TH St Ste 205
Edina, MN 55439-2560
Phone
(952) 914-8065
Fax
(952) 914-8066
NPI assigned
Aug 22, 2007
Last updated
Apr 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7987 MN Primary

Addresses

Primary practice location

8100 W 78TH St Ste 205
Edina, MN 55439-2560

Mailing address

8100 W 78TH St Ste 205
Edina, MN 55439-2560
Phone (952) 914-8065

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Industrial Rehabilitation Services Inc. Physical Therapist PastSince Jun 16, 2014 Accepting new patients
Allina Health System PastSince Apr 5, 2020 Accepting new patients
Allina Health System PastSince Apr 5, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: khendrickson269589@excellian.direct.allina.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1205029493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 W 78TH ST STE 205",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392560",
            "telephone_number": "952-914-8065",
            "fax_number": "952-914-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 W 78TH ST STE 205",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392560",
            "telephone_number": "952-914-8065",
            "fax_number": "952-914-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "KAYSIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.