Active NPI
Patrick C Klos
- Occupational Therapist
- Terre Haute, IN
National Provider Identifier
1104658277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31005905A
- Practice address
- 1725 N 5TH St
Terre Haute, IN 47804-4010 - Phone
- (812) 238-7210
- NPI assigned
- Aug 16, 2024
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31005905A | IN | Primary |
Addresses
Primary practice location
1725 N 5TH St
Terre Haute, IN 47804-4010
Mailing address
1225 N 9TH St
Terre Haute, IN 47807-1117
Phone (812) 249-3168
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 |
|---|---|---|---|
| 31005905A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1104658277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 N 9TH ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478071117",
"telephone_number": "812-249-3168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 N 5TH ST",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478044010",
"telephone_number": "812-238-7210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOS",
"first_name": "PATRICK",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-16",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31005905A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.