Beth Wittersen, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10561-024 Issued in WI

Practice address

7475 Country Club Dr
Golden Valley, MN 55427-4622

Phone

(952) 237-3291

NPI assigned

Nov 11, 2010

Last updated

Mar 10, 2025By 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

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Active Therapy MNGroup PAC ID 2769878099, 22 clinicians

Practice addresses (Care Compare)

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.

• Active Therapy MN

  • Physical Therapist
  • Eden Prairie, MN
  • NPI 1730835257
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1497056139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9130 61 1/2 AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554282610",
            "telephone_number": "952-237-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7475 COUNTRY CLUB DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274622",
            "telephone_number": "952-237-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTERSEN",
        "first_name": "BETH",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10561-024",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9569",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kendra Ann Woodworth, PSYD, LP

• Physical Therapist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.