Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Capernaum Pediatric Therapy, Inc

Organization Specialist · NPI 1619978228

Capernaum Pediatric Therapy, Inc is a Specialist in Richfield, Minnesota. Licensed in Minnesota. Registered with an NPI since 2005.

Licensed in
MN
In the registry since
2005
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2373
Phone: (952) 285-2840
Fax: (952) 285-2830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 2304 (MN)

Record details

NPI number1619978228
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bonna Olson — Physical Therapist/Owner · (952) 285-2840
NPI enumeratedAugust 4, 2005
Last updated in NPPESFebruary 13, 2020
Certification dateFebruary 13, 2020
Mailing address6625 Lyndale Ave S Ste 430, Richfield, MN 55423-2373

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