Individual provider Active NPI

Ilse Kluever, PT

  • Physical Therapist
  • Daytona Beach, FL
National Provider Identifier
1740581602
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25471 Issued in FL
Practice address
1920 Mason Ave
Daytona Beach, FL 32117-5103
Phone
(386) 274-3460
Fax
(386) 274-5513
NPI assigned
Nov 9, 2010
Last updated
Nov 9, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25471 FL Primary

Addresses

Primary practice location

1920 Mason Ave
Daytona Beach, FL 32117-5103

Mailing address

1920 Mason Ave
Daytona Beach, FL 32117-5103
Phone (386) 274-3460

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
25471FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1740581602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-3460",
            "fax_number": "386-274-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-3460",
            "fax_number": "386-274-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUEVER",
        "first_name": "ILSE",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "25471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.