Active NPI
Travis W Kleinendorst, DPT
- Physical Therapist
- Des Moines, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004047
- Practice address
- 3310 SW 9TH St
Des Moines, IA 50315-7647 - Phone
- (515) 244-5005
- Fax
- (515) 244-2202
- NPI assigned
- Aug 6, 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 | 004047 | IA | Primary |
Addresses
Primary practice location
3310 SW 9TH St
Des Moines, IA 50315-7647
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 515-2445
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70255 | Other | IA | WELLMARK BLUE SHIELD |
| 1265623128 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3310 SW 9TH St
Mercyone South Des Moines Physical Therapy
Des Moines, IA 50315-7647
Phone (515) 244-5005
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004047 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinics Inc | Physical Therapist | Current | Accepting new patients |
| Mercy Clinics, Inc. | Current | Accepting new patients | |
| Mercy Clinics, Inc. | Current | Accepting new patients |
Locations
330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454
405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259
3310 SW 9th St
Des Moines, IA 50315
Phone (515) 244-5005
Organizations & group practices 3
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.
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- NPI 1912187394
-
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- NPI 1508741505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1265623128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-515-2445",
"fax_number": "515-244-2202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3310 SW 9TH ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503157647",
"telephone_number": "515-244-5005",
"fax_number": "515-244-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEINENDORST",
"first_name": "TRAVIS",
"middle_name": "W",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-06",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004047",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BLUE SHIELD",
"identifier": "70255",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1265623128",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.