Individual provider Active NPI

Joshua Jordan Klem, PT DPT

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1104471598
Registry record updated Aug 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
296940 Issued in CA
Practice address
1922 Hacienda Dr
Vista, CA 92081-6024
Phone
(760) 295-4175
Fax
(760) 295-4176
NPI assigned
Aug 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 296940 CA Primary

Addresses

Primary practice location

1922 Hacienda Dr
Vista, CA 92081-6024

Mailing address

2622 Colibri LN
Carlsbad, CA 92009-4303
Phone (530) 368-0782

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Physical Therapy, Inc. Physical Therapist PastSince Aug 3, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1564790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564790400000",
    "number": "1104471598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 COLIBRI LN",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920094303",
            "telephone_number": "530-368-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 HACIENDA DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816024",
            "telephone_number": "760-295-4175",
            "fax_number": "760-295-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEM",
        "first_name": "JOSHUA",
        "middle_name": "JORDAN",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-03",
        "last_updated": "2019-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2019; 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.