Active NPI
Kelly Faber, DPT
- Neurology Physical Therapist
- St Louis Park, MN
National Provider Identifier
1619585387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physical Therapist
- Practice address
- 6500 Excelsior Blvd
St Louis Park, MN 55426-4702 - Phone
- (952) 993-5000
- NPI assigned
- Jul 20, 2020
- Last updated
- Jul 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physical Therapist | 2251N0400X | Primary |
Addresses
Primary practice location
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Mailing address
1171 Martin Ave
Fond Du Lac, WI 54935-6375
Phone (920) 979-6764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Interoperability endpoints
- kfaber337597@excellian.direct.allina.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595203200000",
"number": "1619585387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1171 MARTIN AVE",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549356375",
"telephone_number": "920-979-6764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 EXCELSIOR BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554264702",
"telephone_number": "952-993-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABER",
"first_name": "KELLY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-20",
"last_updated": "2020-07-20",
"certification_date": "2020-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Louis Park, MN
- Christine Elizabeth Ewald, O.T.R./L.
- Excel Dentistry
- Excelsior and Grand Chiropractic
- Extendicare Homes, Inc. (Park Health & Rehabilitation Center)
- Extendicare Homes, Inc. (Texas Terrace Care Center)
- Sheila Maureen Fahey, D.C.
- Desiree Marie Falkowski
- Eseferuo Famati, DNP-PMHNP-BC, CNP
- Family Alliance Healthcare LLC
- Family Health Solutions LLC (Visiting Angels)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.