Individual provider Active NPI

Robert John Klopp, P.T.

  • Physical Therapist
  • Lake Elsinore, CA
National Provider Identifier
1225448269
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 23542 Issued in CA
Practice address
425 Diamond Dr Ste 101
Lake Elsinore, CA 92530-4495
Phone
(951) 674-9515
Fax
(951) 674-9517
NPI assigned
Apr 29, 2014
Last updated
Jun 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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 PT 23542 CA Primary

Addresses

Primary practice location

425 Diamond Dr Ste 101
Lake Elsinore, CA 92530-4495

Mailing address

31765 Canyon Estates Dr
Lake Elsinore, CA 92532-0415
Phone (951) 674-4543

Other identifiers 1

IdentifierTypeStateIssuer
PT 23542OtherCAPHYSICAL THERAPY BOARD OF CALIFORNIA LISCENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
PT 23542CAMDPhysical Therapist
23542CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Physical Therapy Inc Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1225448269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31765 CANYON ESTATES DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320415",
            "telephone_number": "951-674-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DIAMOND DR STE 101",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304495",
            "telephone_number": "951-674-9515",
            "fax_number": "951-674-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOPP",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 23542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA  LISCENSE NUMBER",
            "identifier": "PT 23542",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.