Individual provider Active NPI

Olivia Korngable, PT, DPT

  • Physical Therapist
  • Maplewood, MN
National Provider Identifier
1497643357
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13936 Issued in MN
Practice address
1570 Beam Ave Ste 300
Maplewood, MN 55109-3142
Phone
(651) 232-5700
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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 13936 MN Primary

Addresses

Primary practice location

1570 Beam Ave Ste 300
Maplewood, MN 55109-3142

Mailing address

2740 Fairview Ave N Unit 319
Roseville, MN 55113-1370
Phone (507) 923-0797

Other names 1

  • Liv Korngable Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250708000593 MN Practitioner - Physical Therapist in Private Practice 9234643891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

3400 W 66TH St
Suite 290
Edina, MN 55435-2133
Phone (952) 914-1965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13936MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jul 1, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jul 1, 2025 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1570 Beam Ave
Ste 300
Saint Paul, MN 55109
Phone (651) 232-2550

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1497643357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 FAIRVIEW AVE N UNIT 319",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131370",
            "telephone_number": "507-923-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 BEAM AVE STE 300",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093142",
            "telephone_number": "651-232-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNGABLE",
        "first_name": "OLIVIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIV",
            "last_name": "KORNGABLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.