Provider Demographics
NPI:1659348175
Name:CLAUSS, KERRY (PT)
Entity type:Individual
Prefix:MR
First Name:KERRY
Middle Name:
Last Name:CLAUSS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9627
Practice Address - Country:US
Practice Address - Phone:717-757-3537
Practice Address - Fax:717-718-8674
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007247L225100000X
MD26906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000965444OtherHIGHMARK BLUE SHIELD
PA001664800Medicaid
50162511OtherCAPITAL BLUE CROSS
PA0068377000OtherAMERIHEALTH UNDER IBC
PA18444OtherHEALTH AMERICA
PA03182100OtherCAPITAL BLUE CROSS
PA0197900001Medicare NSC