Chereka Shantae Kluttz, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2011018541 Issued in MO

Practice address

250 2ND St E Ste 4E
Bradenton, FL 34208-1028

Phone

(941) 745-7251

NPI assigned

Aug 19, 2011

Last updated

Dec 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckluttz384106@orlandohealth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment Care Compare group NPD
• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Family Medicine

  Medicare reassignment NPD
• Nautilus Health Care Group LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Melbourne, FL
  • NPI 1912013558

  Family Medicine

  Medicare reassignment NPD
• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158
  Medicare reassignment NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837
  NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD
• Mercy Hospital Perry

  dba Mercy Hospital Perry - RHC I

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1639858855

  Family Medicine

  NPD
• Nautilus Health Care Group, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Kokomo, IN
  • NPI 1013234699
  NPD
• Advanced Wound Systems LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1508054271
  NPD (past)
• Physician Specialists of St Lukes LLC

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1235168410

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1053691279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 COACHGATE CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630218853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 2ND ST E STE 4E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081028",
            "telephone_number": "941-745-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTTZ",
        "first_name": "CHEREKA",
        "middle_name": "SHANTAE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2011018541",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "OS19130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Anne Klemkosky, LCSW
• Eric Timothy Kline, DMD
• Meghan Klink
• Kimberly Jean Kloeber, NP
• Ksenia Josephine Klue, PT, DPT
• Chelsey Laurene Knapper, DO
• Carol Ann Knight, LMHC
• Elizabeth Jean Knight
• Mary Angela Knott, CNA
• Knowles Mobile Diagnostics Inc

• Family Medicine Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.