Individual provider Active NPI

Hannah Kloosterman, PT, DPT

  • Pediatric Physical Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1306315072
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT37896 Issued in FL
Practice address
220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899
Phone
(850) 200-4348
NPI assigned
Nov 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT37896 FL Primary

Addresses

Primary practice location

220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899

Mailing address

220 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5899
Phone (850) 200-4350

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

LicenseStateTypeSpecialty
PT37896FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidz Korner CurrentSince Nov 20, 2022 Accepting new patients
Lakeland Hospital at Niles and St Joseph, Inc Past Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients

Locations

220 Eglin Pkwy SE
Fort Walton Beach, FL 32548
Phone (850) 200-4348

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.

NPI Registry JSON

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

{
    "created_epoch": "1543017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1306315072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 EGLIN PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485899",
            "telephone_number": "850-200-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 EGLIN PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485899",
            "telephone_number": "850-200-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOSTERMAN",
        "first_name": "HANNAH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-24",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT37896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.