Individual provider Active NPI

Dwain Ray Klostermann, OT

  • Occupational Therapist
  • Abilene, TX
National Provider Identifier
1699769604
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
100807 Issued in TX
Practice address
4601 Hartford St
Abilene, TX 79605-4603
Phone
(325) 793-3400
Fax
(325) 793-3534
NPI assigned
Sep 6, 2005
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 100807 TX Primary

Addresses

Primary practice location

4601 Hartford St
Abilene, TX 79605-4603

Mailing address

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3400

Other identifiers 2

IdentifierTypeStateIssuer
A008OtherTRICARE
8T0879OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141014001439 TX Practitioner - Occupational Therapist in Private Practice 3072508381 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100807TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The West Texas Rehabilitation Center CurrentSince Nov 25, 2025 Accepting new patients
Work&Rehab LLC Past Accepting new patients
Work & Rehab LLC Occupational Therapist PastSince Aug 1, 2003 Accepting new patients

Locations

4601 Hartford St
Abilene, TX 79605
Phone (325) 793-3400

3001 S Jackson St
San Angelo, TX 76904
Phone (325) 223-6300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1699769604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 HARTFORD ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054603",
            "telephone_number": "325-793-3400",
            "fax_number": "325-793-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 HARTFORD ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054603",
            "telephone_number": "325-793-3400",
            "fax_number": "325-793-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSTERMANN",
        "first_name": "DWAIN",
        "middle_name": "RAY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "100807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8T0879",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.