Individual provider Active NPI

Corinne Elizabeth Wambeke, PT

  • Physical Therapist
  • Edina, MN
National Provider Identifier
1558525873
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8150 Issued in MN
Practice address
7373 France Ave S Ste 204
Edina, MN 55435-4538
Phone
(952) 428-0600
Fax
(952) 428-0610
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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 8150 MN Primary

Addresses

Primary practice location

7373 France Ave S Ste 204
Edina, MN 55435-4538

Mailing address

7373 France Ave S Ste 204
Edina, MN 55435-4538
Phone (952) 428-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424001637 MN Practitioner - Physical Therapist in Private Practice 7315387313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8150MNMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Mar 19, 2024 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Mar 19, 2024 Accepting new patients

Locations

8100 W 78th St
Ste 200
Minneapolis, MN 55439
Phone (952) 914-8065

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

Organizations & group practices 2

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": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1558525873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 204",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354538",
            "telephone_number": "952-428-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 204",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354538",
            "telephone_number": "952-428-0600",
            "fax_number": "952-428-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMBEKE",
        "first_name": "CORINNE",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.