Jaclyn Nicole Kleman

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070,021321 Issued in IL

Practice address

2300 N Edward St
Decatur, IL 62526-4163

Phone

(217) 876-2600

Fax

(217) 876-2615

NPI assigned

Mar 16, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jaclyn Nicole Dintaman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1013300029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2600",
            "fax_number": "217-876-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2600",
            "fax_number": "217-876-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMAN",
        "first_name": "JACLYN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070,021321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "DINTAMAN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly A Kish, APN, CNP
• Therese Kistenfeger, AU.D.
• Suzanne Michelle Kistner-Davis, D.C.
• Shannon Dawn Klaska, BCABA
• Susan M Klein, M.D.
• James Klemens
• Linda Wilson Klemm, FNP-BC
• Kimberly A Knaus, MASSAGE THERAPIST
• Randy Curtis Kneezel, DMD
• Michael Knobeloch, PSY.D.

• Physical Therapist in Decatur, IL
• Providers in Decatur, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.