Grace C Yackly, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13069 Issued in MN

Practice address

3580 Arcade St
Vadnais Heights, MN 55127-7135

Phone

(651) 968-5201

Fax

(651) 968-5903

NPI assigned

Sep 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Summit Orthopedics, LTD

  • Orthopaedic Surgery Physician
  • Woodbury, MN
  • NPI 1306899463
  Medicare reassignment Care Compare group NPD
• Summit Orthopedics LTD

  • Orthopaedic Surgery Physician
  • Eden Prairie, MN
  • NPI 1417639626
  NPD

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1639654239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 ARCADE ST",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277135",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACKLY",
        "first_name": "GRACE",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa M Wollan, MD
• Paul Severin Wood, DC
• Colleen E Woodington, PA
• Pamela D Wright, OTR/L, CHT
• Dee Xiong
• James Timothy Young, MD
• Elena Kathleen Zadow
• Tracy B Zarembinski
• Keli K Zemke, OT
• Paul K Zollinger

• Physical Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.