Tracy Kletzing, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110002748 Issued in VA

Practice address

2900 Lamb Cir Ste 250
Christiansburg, VA 24073-6345

Phone

(540) 772-1514

NPI assigned

Jun 3, 2008

Last updated

Jul 14, 2021By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Blue Ridge Physical Medicine

  • Pain Clinic/Center
  • Roanoke, VA
  • NPI 1710173679
  NPD (past)

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1073772273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4582 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145144",
            "telephone_number": "540-772-8052",
            "fax_number": "540-772-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LAMB CIR STE 250",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240736345",
            "telephone_number": "540-772-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLETZING",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkletzing21610@direct.carilionclinic.org",
            "affiliation": "N",
            "endpointDescription": "tkletzing21610@direct.carilionclinic.org",
            "address_1": "2900 Lamb Cir Ste 250",
            "city": "Christiansburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240736345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Lynn Kirkner
• Anand T Kishore, MD
• Lakshmi T Kishore, MD
• Lauren Kitts, CRNA
• Lori M Klein, SLP
• Victoria Klostermann, CRNA
• Paul Thomas Knackstedt
• Michael C Knight, DO
• Thomas G Kraemer, MD
• Kroger Limited Partnership I (Kroger Pharmacy)

• Medical Physician Assistant in Christiansburg, VA
• Providers in Christiansburg, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.