Active NPI
Kerry Richard Kliever, MPT
- Physical Therapist
- Lake Mary, FL
National Provider Identifier
1245353580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3458
- Practice address
- 250 International Pkwy
Suite 260
Lake Mary, FL 32746-5030 - Phone
- (407) 833-8815
- NPI assigned
- Apr 10, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3458 | OR | Primary |
Addresses
Primary practice location
250 International Pkwy
Suite 260
Lake Mary, FL 32746-5030
Mailing address
350 Arlowene CT
Jefferson, OR 97352-9481
Phone (541) 619-0966
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 |
|---|---|---|---|
| 3458 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245353580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 ARLOWENE CT",
"city": "JEFFERSON",
"state": "OR",
"postal_code": "973529481",
"telephone_number": "541-619-0966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 INTERNATIONAL PKWY",
"address_2": "SUITE 260",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465030",
"telephone_number": "407-833-8815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLIEVER",
"first_name": "KERRY",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "3458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.