Kaci Ann Carroll, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11821 Issued in MN

Practice address

688 Wildwood Rd
Mahtomedi, MN 55115-1812

Phone

(651) 429-9947

Fax

(651) 429-1029

NPI assigned

Oct 8, 2020

Last updated

Jun 26, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kaci Hemmesch Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fitness Focus, Inc.Group PAC ID 3577736396, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Fitness Focus, Inc.

  dba Fitness Focus

  • Physical Therapy Clinic/Center
  • Mahtomedi, MN
  • NPI 1720156680

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1841897279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 WILDWOOD RD",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151812",
            "telephone_number": "651-429-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 WILDWOOD RD",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151812",
            "telephone_number": "651-429-9947",
            "fax_number": "651-429-1029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 W Front Ave",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "58504",
            "country_code": "US",
            "telephone_number": "701-751-0994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Margaret Ave NE",
            "address_purpose": "LOCATION",
            "city": "Blackduck",
            "state": "MN",
            "postal_code": "566304509",
            "country_code": "US",
            "telephone_number": "218-835-3425",
            "fax_number": "218-835-3433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3835 Supreme Ct NW Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566014485",
            "country_code": "US",
            "telephone_number": "218-444-8280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KACI",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2520",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACI",
            "last_name": "HEMMESCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bloom Physical Therapy and Wellness LLC
• Joanell A Bohmert, PT
• Bohn Counseling Associates, Inc,
• Michael David Carlson, MSW, LICSW
• Ivan Alejandro Carrillo, DC
• Christina Marie Case, LMFT
• Lisa Kerstin Channon I
• Audrey Marie Chaput, OTR/L
• City of Mahtomedi (Mahtomedi Fire Department)
• Richard Winfield Copeland Jr., DDS

• Physical Therapist in Mahtomedi, MN
• Providers in Mahtomedi, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.