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

Active since February 02, 2007CLIA Certified · 4 labs
630 W PLYMOUTH AVE, DELAND, FL 32720(386) 734-3654(386) 943-8087 Get Directions Write a Review

NPPES record last updated: September 6, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Daytona Heart Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAYTONA HEART GROUP (NPI 1164560041) is a healthcare organization registered as a cardiovascular disease in Deland, Florida and active in the NPI registry since February 2007. The organization holds 4 active CLIA laboratory certificates and lists Kathy T Phillips, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1164560041
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameLEWIS & KLANCKE CARDIOLOGY, P.A.
Location Address630 W PLYMOUTH AVEDeland, FL 32720-3260
Mailing Address695 N Clyde Morris BlvdDaytona Beach, FL 32114-2321 · (386) 258-8722 · Fax (386) 258-8659
Phone(386) 734-3654
Fax(386) 943-8087
Organization SubpartYes
Authorized OfficialKathy T PhillipsCredentialing Coordinator · (386) 258-8722
Enumeration DateFebruary 2, 2007
Last NPPES UpdateSeptember 6, 2022
NPPES CertifiedSeptember 6, 2022
✔ NPI 1164560041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
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.
Also ListedInternal Medicine · Clinical Cardiac ElectrophysiologyTaxonomy 207RC0001X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X
630 W PLYMOUTH AVE, Deland, FL 32720
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Other Names 1

Doing Business AsDaytona Heart Group

Other Identifiers 1

Medicaid378998500FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0994863

Daytona Heart Group · Daytona Beach, FL
Active · expires Jan 3, 2028
CLIA Number10D0994863
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorRoosevelt J. Harris
Laboratory Phone(386) 258-8722
Laboratory LocationDaytona Heart Group695 North Clyde Morris Blvd, Daytona Beach, FL 32114
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2059607

Lewis And Klancke Cardiology PA Dba Daytona Heart Group · Deland, FL
Active · expires May 27, 2027
CLIA Number10D2059607
Laboratory TypePhysician Office
Certificate Effective DateMay 28, 2025
Certificate Expiration DateMay 27, 2027
Laboratory DirectorRoosevelt Harris
Laboratory Phone(386) 258-8722
Laboratory LocationLewis And Klancke Cardiology PA Dba Daytona Heart Group630 W Plymouth Ave, Deland, FL 32720
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2062442

Lewis And Klancke Cardiology PA Dba Daytona Heart Group · Port Orange, FL
Active · expires Jul 16, 2027
CLIA Number10D2062442
Laboratory TypePhysician Office
Certificate Effective DateJuly 17, 2025
Certificate Expiration DateJuly 16, 2027
Laboratory DirectorRoosevelt Harris
Laboratory Phone(386) 258-8722
Laboratory LocationLewis And Klancke Cardiology PA Dba Daytona Heart Group780 Dunlawton Ave Unit 101, Port Orange, FL 32127
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2062444

Lewis And Klancke Cardiology PA Dba Daytona Heart Group · Orange City, FL
Active · expires Jul 16, 2027
CLIA Number10D2062444
Laboratory TypePhysician Office
Certificate Effective DateJuly 17, 2025
Certificate Expiration DateJuly 16, 2027
Laboratory DirectorRoosevelt Harris
Laboratory Phone(386) 258-8722
Laboratory LocationLewis And Klancke Cardiology PA Dba Daytona Heart Group938 Saxon Blvd Ste 101 C, Orange City, FL 32763
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KASEY MAUREEN LUSTIK
Nurse Practitioner (Acute Care)
630 W PLYMOUTH AVE
DELAND, FL 32720
Volusia County (386) 734-3654
OSCAR DERMOTT WEST MD
Internal Medicine (Cardiovascular Disease)
630 W PLYMOUTH AVE
DELAND, FL 32720
Volusia County (386) 734-3654
DR. FRANCIS ALEXANDER REED JR. MD
Internal Medicine (Cardiovascular Disease)
630 W PLYMOUTH AVE
DELAND, FL 32720
Volusia County (386) 734-3654
KATHERINE ANN YELVINGTON APRN
Family Medicine
630 W PLYMOUTH AVE
DELAND, FL 32720
Volusia County (386) 734-3654

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lewis & Klancke Cardiology, P.A.'s NPI number?

The NPI number for Lewis & Klancke Cardiology, P.A. is 1164560041. It was assigned to this organization in the NPPES registry on February 2, 2007. The provider is doing business as Daytona Heart Group.

Where is Lewis & Klancke Cardiology, P.A. located?

Lewis & Klancke Cardiology, P.A. is located at 630 W Plymouth Ave, Deland, FL 32720. The listed phone number is (386) 734-3654.

What is Lewis & Klancke Cardiology, P.A.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Lewis & Klancke Cardiology, P.A. hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Lewis & Klancke Cardiology, P.A. accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Lewis & Klancke Cardiology, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lewis & Klancke Cardiology, P.A. was last updated on September 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.