Active NPI
Mark Kleckner, P.T.
- Physical Therapist
- Lexington, KY
National Provider Identifier
1003273350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-001913
- Practice address
- 1722 Sharkey Way
Lexington, KY 40511-2028 - Phone
- (859) 245-0692
- NPI assigned
- Jan 18, 2016
- Sex
- Male
- 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 | PT-001913 | KY | Primary |
Addresses
Primary practice location
1722 Sharkey Way
Lexington, KY 40511-2028
Mailing address
1722 Sharkey Way
Lexington, KY 40511-2028
Phone (859) 245-0692
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-001913 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453075200000",
"number": "1003273350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 SHARKEY WAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405112028",
"telephone_number": "859-245-0692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 SHARKEY WAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405112028",
"telephone_number": "859-245-0692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLECKNER",
"first_name": "MARK",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-18",
"last_updated": "2016-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "PT-001913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.