Individual provider Active NPI

Elizabeth Cunningham Klemm, PT, MPH

  • Orthopedic Physical Therapist
  • College Station, TX
National Provider Identifier
1770837361
Registry record updated Nov 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1059699 Issued in TX
Practice address
4095 State Highway 6 S
College Station, TX 77845-9491
Phone
(979) 690-1999
NPI assigned
Nov 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1059699 TX Primary

Addresses

Primary practice location

4095 State Highway 6 S
College Station, TX 77845-9491

Mailing address

4095 State Highway 6 S
College Station, TX 77845-9491
Phone (979) 690-1999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130824000155 TX Practitioner - Physical Therapist in Private Practice 4284877184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axis Therapy ServicesGroup PAC ID 8426354200, 3 clinicians

Practice addresses (Care Compare)

1605 Rock Prairie Rd
Suite 318
College Station, TX 77845-8358
Phone (979) 704-6482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1059699TXMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Therapy Services Orthopedic CurrentSince Jan 4, 2016 Accepting new patients
Wellpoint Physical Therapy Services, P.C. Orthopedic PastSince Sep 2, 2003 Accepting new patients
Cliff Walker Chiropractic, PC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351987200000",
    "number": "1770837361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4095 STATE HIGHWAY 6 S",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778459491",
            "telephone_number": "979-690-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 STATE HIGHWAY 6 S",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778459491",
            "telephone_number": "979-690-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMM",
        "first_name": "ELIZABETH",
        "middle_name": "CUNNINGHAM",
        "name_prefix": "Ms.",
        "credential": "PT, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-04",
        "last_updated": "2012-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1059699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.