Individual provider Active NPI

Kaila Prestrud, DR. PHYSICAL THERAPY

  • Physical Therapist
  • Plymouth, MN
National Provider Identifier
1700444973
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11451 Issued in MN
Practice address
14130 23Rd Ave N
Plymouth, MN 55447
Phone
(763) 383-7666
Fax
(763) 383-6013
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 11451 MN
Physical Therapist 225100000X 11451 MN Primary

Addresses

Primary practice location

14130 23Rd Ave N
Plymouth, MN 55447

Mailing address

14130 23Rd Ave N
Plymouth, MN 55447
Phone (763) 383-7666

Other practice location 1

14635 Pennock Ave Ste 300
Apple Valley, MN 55124-6588
Phone (651) 994-9644

Other practice location 2

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone (651) 994-9644

Other names 1

  • Kaila Potting Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190712001474 MN Practitioner - Physical Therapist in Private Practice 5496080467 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Therapy Center, Inc Physical Therapist CurrentSince Jun 13, 2019 Accepting new patients
Children'S Therapy Ctr, Inc Pediatrics PastSince Jun 13, 2019 Accepting new patients

Locations

14635 Pennock Ave
Ste 300
Apple Valley, MN 55124
Phone (651) 994-9644

2795 Pilot Knob Rd
Ste 100
Saint Paul, MN 55121
Phone (651) 994-9644

Organizations & group practices 3

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1700444973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14130 23RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "763-383-7666",
            "fax_number": "763-383-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14130 23RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "763-383-7666",
            "fax_number": "763-383-6013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14635 Pennock Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551246588",
            "country_code": "US",
            "telephone_number": "651-994-9644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2795 Pilot Knob Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551211930",
            "country_code": "US",
            "telephone_number": "651-994-9644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRESTRUD",
        "first_name": "KAILA",
        "credential": "DR. PHYSICAL THERAPY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MN",
            "license": "11451",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILA",
            "last_name": "POTTING",
            "credential": "DR. PHYSICAL THERAPY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.