Lewis & Klancke Cardiology, P.a.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

LEWIS & KLANCKE CARDIOLOGY, P.A.

Practice address

630 W Plymouth Ave
Deland, FL 32720-3260

Phone

(386) 734-3654

Fax

(386) 943-8087

NPI assigned

Feb 2, 2007

Organization subpart

Yes

Parent organization

LEWIS & KLANCKE CARDIOLOGY, P.A.As reported in NPPES

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

Authorized official

Name

Kathy T Phillips

Title

Credentialing Coordinator

Phone

(386) 258-8722

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Daytona Heart Group Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Lewis Klancke Cardiology PA7 organizations share this tax ID, including this one

Part of

Lewis Klancke Cardiology PA

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

• Lewis & Klancke Cardiology PA

  • Cardiovascular Disease Physician
  • Orange City, FL
  • NPI 1558405639
  NPD tax ID
• Lewis & Klancke Cardiology PA

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1669589263
  NPD tax ID
• Lewis & Klancke Cardiology PA

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1689395675
  NPD tax ID
• Lewis & Klancke Cardiology, P.a.

  • Cardiovascular Disease Physician
  • Port Orange, FL
  • NPI 1205557691
  NPD tax ID
• Lewis & Klancke Cardiology, P.a.

  • Cardiovascular Disease Physician
  • Deltona, FL
  • NPI 1376264788
  NPD tax ID
• Lewis & Klancke Cardiology, P.a.

  • Cardiovascular Disease Physician
  • Edgewater, FL
  • NPI 1548981947
  NPD tax ID

Locations

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1164560041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142321",
            "telephone_number": "386-258-8722",
            "fax_number": "386-258-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203260",
            "telephone_number": "386-734-3654",
            "fax_number": "386-943-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS & KLANCKE CARDIOLOGY, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEWIS & KLANCKE CARDIOLOGY, P.A.",
        "enumeration_date": "2007-02-02",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "386-258-8722"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378998500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daytona Heart Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kendra Lee
• Patrick Lee, M.D.
• Thomas C Lee, M.D.
• Jennifer Legg
• Nicolette Marie Leiva, DPT
• Sharon Suzanne Lewis, M.S., L.M.H.C.
• Lifes Path LLC
• Jennifer Evans Lightfoot, LMT
• Lighthouse Home Medical
• Henessy Linares Johnson, BSN, RN

• All providers in Deland, FL
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.