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

Kiley Lavanger, PT, DPT

Individual provider Physical Therapist · NPI 1104641091

Kiley Lavanger, PT, DPT is a Physical Therapist in Private Practice in Saint Paul, Minnesota. Qualified in 2022, 4 years ago. Practices with Fairview Express Care, a 1,964-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2024
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1700 University Ave W
Saint Paul, MN 55104-3727
Phone: (651) 232-5000
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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 12822 (MN)

Record details

NPI number1104641091
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedNovember 18, 2024
Last updated in NPPESNovember 18, 2024
Certification dateNovember 17, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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