Active NPI
Joshua Kalette
- Physical Therapist
- Vernon Hills, IL
National Provider Identifier
1992050504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070024968
- Practice address
- 402 Elm Tree LN
Vernon Hills, IL 60061-1806 - Phone
- (315) 382-1294
- NPI assigned
- Jul 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 62 035239 | NY | |
| Physical Therapist | 225100000X | 070024968 | IL | Primary |
Addresses
Primary practice location
402 Elm Tree LN
Vernon Hills, IL 60061-1806
Mailing address
102 Pine Ridge Rd
Fayetteville, NY 13066-2239
Other practice location 1
5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311
Phone (800) 330-7711 ext. 247
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070024968 | IL | MD | Physical Therapist |
| 62 035239 | NY | MD | Physical Therapist |
| 035239 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1992050504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 PINE RIDGE RD",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130662239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 ELM TREE LN",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611806",
"telephone_number": "315-382-1294"
}
],
"practiceLocations": [
{
"address_1": "5535 S Williamson Blvd",
"address_2": "Ste 774",
"address_purpose": "LOCATION",
"city": "Port Orange",
"state": "FL",
"postal_code": "321288311",
"country_code": "US",
"telephone_number": "800-330-7711 x247",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KALETTE",
"first_name": "JOSHUA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-19",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "62 035239",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070024968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.