NPIMap

Organization Active NPI

KLD Therapy PLLC

Doing business as Active Rehab and Fitness

  • Physical Therapist
  • Lexington, KY
National Provider Identifier
1689903320
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3352 Issued in KY
Legal business name
KLD THERAPY PLLC
Doing business as
Active Rehab and Fitness
Practice address
880 Corporate Dr Ste 202
Lexington, KY 40503-5449
Phone
(859) 797-5513
Fax
(859) 898-0538
NPI assigned
Dec 8, 2009
Last updated
Jul 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Authorized official

Name
Mr. Keith Andrew Duerler, P.T.NPI 1114099330
Title
Owner
Phone
(859) 797-5513

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Physical Therapist 225100000X 3352 KY Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

880 Corporate Dr Ste 202
Lexington, KY 40503-5449

Mailing address

PO Box 911063
Lexington, KY 40591-1063
Phone (859) 797-5513

Other names 1

  • Active Rehab and Fitness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091230000160 KY Part B Supplier - Clinic/Group Practice 7618017401 Receives reassigned benefits from 8 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

153 Patchen Dr
Ste 67
Lexington, KY 40517
Phone (859) 797-5513

163 Old Todds Rd
Ste 115
Lexington, KY 40509
Phone (317) 519-3926

324 N Ashland Ave
Lexington, KY 40502
Phone (859) 797-5513

332 N Ashland Ave
Lexington, KY 40502
Phone (859) 797-5513

3882 Mall Rd
Lexington, KY 40503
Phone (859) 644-8993

880 Corporate Dr
Ste 202
Lexington, KY 40503
Phone (859) 460-7778

Practitioners & affiliated clinicians

Practitioners 9

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": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1689903320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911063",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405911063",
            "telephone_number": "859-797-5513",
            "fax_number": "859-898-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 CORPORATE DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035449",
            "telephone_number": "859-797-5513",
            "fax_number": "859-898-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLD THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2023-07-11",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "DUERLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-797-5513",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "3352",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Rehab and Fitness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Active Rehab and Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.