Carrie Ann Kubala, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017605 Issued in PA

Practice address

511 Old Lancaster Rd Ste 12
Berwyn, PA 19312-1671

Phone

(610) 225-2451

NPI assigned

Apr 16, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• JMB Therapy Services LLC

  • Physical Therapist
  • Berwyn, PA
  • NPI 1396028460
  NPD

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1407071103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 OLD LANCASTER RD STE 12",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121671",
            "telephone_number": "610-225-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 OLD LANCASTER RD STE 12",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121671",
            "telephone_number": "610-225-2451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "HHH, 51-55 North RT 9W",
            "address_purpose": "LOCATION",
            "city": "West Haverstraw",
            "state": "NY",
            "postal_code": "10993",
            "country_code": "US",
            "telephone_number": "845-786-4617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBALA",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028362-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keystone Hospice and Palliative Care Inc
• Muniya Shreyashi Khanna, PHD
• Lauren Kin, CRNP
• Khrystyna Kobylynets, NP
• Kenneth Kondracki
• Dawn Marie Kutteroff, CRNP
• Jennifer Lachance-Poirrier, LPC, ATR-BC, LCAT
• Karen S Lally, DPT
• John Douglas Lawson, DO
• Steven Lee

• Physical Therapist in Berwyn, PA
• Providers in Berwyn, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.