Klare Physical Therapy, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1096576 Issued in TX

Legal business name

KLARE PHYSICAL THERAPY, PC

Practice address

702 E Mimosa St
Rockport, TX 78382-4151

Phone

(361) 729-8838

Fax

(361) 729-9508

NPI assigned

Oct 25, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Wade Klare, LPTNPI 1861491961

Title

Owner

Phone

(361) 729-8838

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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.

• Kenneth Wade Klare, LPT

  • Physical Therapist
  • Rockport, TX
  • NPI 1861491961
  Medicare reassignment NPD Authorized official
• Kathryn Jo Thompson, OTR

  • Specialist
  • Rockport, TX
  • NPI 1659354033
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1861671919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E MIMOSA ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783824151",
            "telephone_number": "361-729-8838",
            "fax_number": "361-729-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E MIMOSA ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783824151",
            "telephone_number": "361-729-8838",
            "fax_number": "361-729-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLARE PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "KLARE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-729-8838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1096576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400153",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1747277",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "83755T",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "7019083",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasiri Kennedy, M.D.
• Laura Margaret Kieschnick, PHARMD
• Karl Kietzke, M.D.
• Deedee Marie Kilough
• Kimberly Maroney, M.D., P.a.
• Kenneth Wade Klare, LPT
• Crystal Lynn Landgraf, FNP-BC
• Linda Herndon Lee, LPC
• Linda Faye Lemmons, SPEECH PATHOLOGIST
• Neil Irwin Leva, M.S.W.

• Physical Therapy Clinic/Center in Rockport, TX
• Providers in Rockport, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.