Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Ruth-Carlson Weiske, DPT

Individual provider Physical Therapist · NPI 1902304777

Kelly Ruth-Carlson Weiske, DPT is a Physical Therapist in Private Practice in Eagan, Minnesota. Qualified in 2017, 9 years ago. Practices with Fairview Express Care, a 1,964-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2018
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3365 Central Park Village Dr # 100
Eagan, MN 55121-7707
Phone: (952) 835-4512
Fax: (888) 425-0398
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11418 (MN)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1902304777
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedJanuary 26, 2018
Last updated in NPPESAugust 16, 2021
Certification dateAugust 16, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Eagan