Active NPI
Kayla Marie Dockendorf
- Physical Therapist
- Waite Park, MN
National Provider Identifier
1962994129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 901 3Rd St N
Waite Park, MN 56387-1964 - Phone
- (320) 217-8480
- NPI assigned
- Jun 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
901 3Rd St N
Waite Park, MN 56387-1964
Mailing address
14623 County Road 2
Watkins, MN 55389-9603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4632 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528070400000",
"number": "1962994129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14623 COUNTY ROAD 2",
"city": "WATKINS",
"state": "MN",
"postal_code": "553899603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 3RD ST N",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871964",
"telephone_number": "320-217-8480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOCKENDORF",
"first_name": "KAYLA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-04",
"last_updated": "2018-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waite Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.