DAYTONA HEART GROUP
NPI 1164560041
Internal Medicine - Cardiovascular Disease in Deland, FL

NPI Status: Active since February 02, 2007

Contact Information

630 W PLYMOUTH AVE
DELAND, FL
ZIP 32720
Phone: (386) 734-3654
Fax: (386) 943-8087

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  • Organization
  • Internal Medicine
  • Cardiovascular Disease
  • Accepts Insurance
  • CLIA Number: 10D0994863
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-03-2028

About DAYTONA HEART GROUP

This page provides the complete NPI Profile along with additional information for Daytona Heart Group, an internist established in Deland, Florida operating as a Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1164560041 assigned on February 2007. The practitioner's primary taxonomy code is 207RC0000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Daytona Heart Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Daytona Heart Group. The authorized official of this NPI record is Kathy T Phillips (Credentialing Coordinator)

NPI
1164560041
Provider Legal Name
LEWIS & KLANCKE CARDIOLOGY, P.A.
Other Organization Name
DAYTONA HEART GROUP
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
630 W PLYMOUTH AVE DELAND, FL 32720
Location Phone
(386) 734-3654
Location Fax
(386) 943-8087
Mailing Address
695 N CLYDE MORRIS BLVD DAYTONA BEACH, FL 32114
Mailing Phone
(386) 258-8722
Mailing Fax
(386) 943-8087
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
02-02-2007
Last Update Date
09-06-2022
Code Navigator

An internist like Daytona Heart Group is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207RC0001XAllopathic & Osteopathic Physicians

Internal Medicine
Clinical Cardiac Electrophysiology

 
2207RI0011XAllopathic & Osteopathic Physicians

Internal Medicine
Interventional Cardiology

 
3207UN0901XAllopathic & Osteopathic Physicians

Nuclear Medicine
Nuclear Cardiology

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-05 (Rewards) - POS
  • BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-18 (Rewards) - POS
  • BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KATHY T PHILLIPS

Authorized Official Title
CREDENTIALING COORDINATOR
Authorized Official Phone
(386) 258-8722

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
378998500MEDICAID (05)FL 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D0994863
Facility Type
Physician Office
Certificate Effective Date
January 04, 2026
Certificate Expiration Date
January 03, 2028
Laboratory Director
ROOSEVELT J. HARRIS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Daytona Heart Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164560041, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 5 → 10 → 1 0 → 0 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 1 + 0 + 6 + 0 + 0 + 8 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1164560041.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Internal Medicine (Cardiovascular Disease)
630 W PLYMOUTH AVE
DELAND, FL 32720
Internal Medicine (Cardiovascular Disease)
630 W PLYMOUTH AVE
DELAND, FL 32720
Nurse Practitioner (Acute Care)
630 W PLYMOUTH AVE
DELAND, FL 32720
Family Medicine
630 W PLYMOUTH AVE
DELAND, FL 32720

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164560041, enumerated as an "organization" on February 02, 2007.

The provider is located at 630 W PLYMOUTH AVE DELAND, FL 32720 and the phone number is (386) 734-3654.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Florida. Please consult your insurance carrier or call the provider to verify.