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

Last updated

Aug 5, 2021By the provider in NPPES

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

• JMB Therapy Services LLC

  dba Dynamic Home Therapy

  • 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": []
}

• Muniya Shreyashi Khanna, PHD
• Lauren Kin, CRNP
• Serena Klingensmith
• 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.