Individual provider Active NPI

Carol Marie Dubbels, MPT

  • Physical Therapist
  • Edina, MN
National Provider Identifier
1770612392
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12918 Issued in MN
Practice address
6550 York Ave S Ste 600
Edina, MN 55435-2367
Phone
(952) 941-3311
Fax
(952) 944-2004
NPI assigned
Mar 2, 2007
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05356 OR
Physical Therapist 225100000X PT61239273 WA
Physical Therapist 225100000X 1168328 TX
Physical Therapist 225100000X 12918 MN Primary

Addresses

Primary practice location

6550 York Ave S Ste 600
Edina, MN 55435-2367

Mailing address

6550 York Ave S Ste 600
Edina, MN 55435-2367
Phone (952) 941-3311

Other practice location 1

2550 University Ave W Ste 143N
Saint Paul, MN 55114-1098
Phone (952) 941-3311

Other names 1

  • Carol Marie Morgan Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031002971 MN Practitioner - Physical Therapist in Private Practice 5890890719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Texas Southwestern Medical School at Dallas, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physical Therapy LLCGroup PAC ID 0143643833, 2 clinicians

Practice addresses (Care Compare)

14440 28TH PL N
Suite 200
Plymouth, MN 55447-4854
Phone (612) 707-0169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05356ORMDPhysical Therapist
1168328TXMDPhysical Therapist
PT61239273WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Physical Therapy LLC Physical Therapist CurrentSince Apr 29, 2024 Accepting new patients
Spine and Orthopedic Rehab of VA Inc Physical Therapist Past Accepting new patients

Locations

14440 28th Pl N
Ste 200
Plymouth, MN 55447
Phone (612) 707-0169

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1770612392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 600",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352367",
            "telephone_number": "952-941-3311",
            "fax_number": "952-944-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S STE 600",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352367",
            "telephone_number": "952-941-3311",
            "fax_number": "952-944-2004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 University Ave W Ste 143N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141098",
            "country_code": "US",
            "telephone_number": "952-941-3311",
            "fax_number": "952-944-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBBELS",
        "first_name": "CAROL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "05356",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61239273",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1168328",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "MORGAN",
            "middle_name": "MARIE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 12, 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.