Individual provider Active NPI

Keri Dahlstrom

  • Physical Therapist
  • Nevada City, CA
National Provider Identifier
1932546587
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23063 Issued in CA
Practice address
351 Providence Mine Rd
Nevada City, CA 95959-2980
Phone
(530) 263-6974
Fax
(530) 362-4640
NPI assigned
May 22, 2013
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT23063 CA
Physical Therapist 225100000X 23063 CA Primary

Addresses

Primary practice location

351 Providence Mine Rd
Nevada City, CA 95959-2980

Mailing address

12535 Madrone Forest Dr
Nevada City, CA 95959-9673
Phone (530) 477-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130620000558 CA Practitioner - Physical Therapist in Private Practice 1254570310 Reassigns benefits to 2 organizations
I20180308000657 CA Practitioner - Physical Therapist in Private Practice 1254570310 Practice locations: Nevada City, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 Providence Mine Rd
Suite 122
Nevada City, CA 95959-2955
Phone (530) 263-6974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23063CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Hill Physical Therapy PC Physical Therapist CurrentSince Jul 1, 2013 Accepting new patients
Spring Hill Physical Therapy and Acupuncture Physical Therapist PastSince Jul 1, 2013 Accepting new patients

Locations

300 Sierra College Dr
Ste 165
Grass Valley, CA 95945
Phone (530) 274-2320

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, 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": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1932546587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12535 MADRONE FOREST DR",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959599673",
            "telephone_number": "530-477-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 PROVIDENCE MINE RD",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592980",
            "telephone_number": "530-263-6974",
            "fax_number": "530-362-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLSTROM",
        "first_name": "KERI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23063",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "23063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.