NPIMap

Organization Active NPI

Kinetic Physical Therapy Institute

  • Physical Therapist
  • Woodbury, MN
National Provider Identifier
1487785044
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KINETIC PHYSICAL THERAPY INSTITUTE
Practice address
731 Bielenberg Dr
Suite 107
Woodbury, MN 55125-1700
Phone
(651) 730-7771
Fax
(651) 730-7772
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Authorized official

Name
Carrie Langer, MPT, ATR, PRCNPI 1104957406
Title
Co-Owner
Phone
(651) 730-7771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

731 Bielenberg Dr
Suite 107
Woodbury, MN 55125-1700

Mailing address

731 Bielenberg Dr
Suite 107
Woodbury, MN 55125-1700
Phone (651) 730-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051110000741 MN Part B Supplier - Clinic/Group Practice 8123046885 Receives reassigned benefits from 4 practitioners
Practice locations: Woodbury, MN

National Provider Directory

National Provider Directory

Locations

3060 Woodbury Dr
Woodbury, MN 55129
Phone (651) 427-4893

783 Radio Dr
Ste 105
Woodbury, MN 55125
Phone (651) 730-7771

731 Bielenberg Dr
Ste 107
Woodbury, MN 55125
Phone (651) 730-7771

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1487785044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR",
            "address_2": "SUITE 107",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "651-730-7771",
            "fax_number": "651-730-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR",
            "address_2": "SUITE 107",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251700",
            "telephone_number": "651-730-7771",
            "fax_number": "651-730-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC PHYSICAL THERAPY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "LANGER",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-730-7771",
        "authorized_official_credential": "MPT, ATR, PRC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.