Individual provider Active NPI

Lee Ann Josette Klocko, CRNP

  • Family Nurse Practitioner
  • Fleetwood, PA
National Provider Identifier
1558712018
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016246 Issued in PA
Practice address
14351 Kutztown Rd
Fleetwood, PA 19522-9273
Phone
(610) 944-8800
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP016246 PA Primary

Addresses

Primary practice location

14351 Kutztown Rd
Fleetwood, PA 19522-9273

Mailing address

2100 Mack Blvd
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

42 N Main St
Pittston, PA 18640-1916
Phone (570) 602-5610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170622000741 PA Practitioner - Nurse Practitioner 4981972502 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians
Onsight Health Care, LLCGroup PAC ID 0840338059, 32 clinicians

Practice addresses (Care Compare)

14351 Kutztown Rd
Fleetwood, PA 19522-9273
Phone (610) 944-8800

2595 Interstate Dr
Suite 103
Harrisburg, PA 17110-9378
Phone 50224424205415

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2023 Accepting new patients
Geisinger Clinic CurrentSince Sep 24, 2018 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family CurrentSince Sep 11, 2023 Accepting new patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Geisinger Clinic CurrentSince Sep 24, 2018 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2023 Accepting new patients
Family Care Centers Inc. CurrentSince Apr 22, 2017 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Geisinger Clinic Current Accepting new patients
Family Care Centers Inc CurrentSince Apr 22, 2017 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

174 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

100 N Academy Ave
Danville, PA 17822

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

14351 Kutztown Rd
Fleetwood, PA 19522
Phone (610) 944-8800

384 Airport Rd
Hazle Township, PA 18202
Phone (570) 501-1242

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

3371 Route 100
Macungie, PA 18062
Phone (610) 336-8277

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

Interoperability endpoints

  • Direct secure messaging: lklocko233069@direct2.lvhn.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1558712018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14351 KUTZTOWN RD",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "195229273",
            "telephone_number": "610-944-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 N Main St",
            "address_purpose": "LOCATION",
            "city": "Pittston",
            "state": "PA",
            "postal_code": "186401916",
            "country_code": "US",
            "telephone_number": "570-602-5610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOCKO",
        "first_name": "LEE ANN",
        "middle_name": "JOSETTE",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleetwood, PA

Sources for this page

Verify at the official NPI Registry.