Organization Active NPI

James J Klocek DPM PA

  • Podiatrist
  • Salisbury, MD
National Provider Identifier
1447442462
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1199 Issued in MD
Legal business name
JAMES J KLOCEK DPM PA
Practice address
106 Milford St
Suite 504-a
Salisbury, MD 21804-6953
Phone
(410) 546-2288
Fax
(410) 546-2339
NPI assigned
Aug 14, 2007
Last updated
Nov 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

Name
Dr. James Joseph Klocek, DPMNPI 1013904788
Title
Owner
Phone
(410) 546-2288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1199 MD Primary

Addresses

Primary practice location

106 Milford St
Suite 504-a
Salisbury, MD 21804-6953

Mailing address

106 Milford St
Suite 504-a
Salisbury, MD 21804-6953
Phone (410) 546-2288

Other identifiers 3

IdentifierTypeStateIssuer
363748400MedicaidMD
KCV6JAOtherMDBCBS
1013904788OtherMDNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120412000666 MD Part B Supplier - Clinic/Group Practice 0446411722 Receives reassigned benefits from 1 practitioner
Practice locations: Salisbury, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1447442462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 504-A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-546-2288",
            "fax_number": "410-546-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 504-A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-546-2288",
            "fax_number": "410-546-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES J KLOCEK DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "KLOCEK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-546-2288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "1199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363748400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "KCV6JA",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013904788",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.