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DAYTONA HEART GROUP
NPI 1205557691
Internal Medicine - Cardiovascular Disease in Port Orange, FL

Active since September 06, 2022CLIA 10D2059607 · Waiver
780 DUNLAWTON AVE STE 101, PORT ORANGE, FL 32127(386) 265-5926(386) 265-5928 Get Directions Write a Review

NPPES record last updated: October 3, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Oct 3, 2023, Sep 6, 2022 (2 updates tracked since 2022).

About Daytona Heart Group NPPES

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

DAYTONA HEART GROUP (NPI 1205557691) is a healthcare organization registered as a cardiovascular disease in Port Orange, Florida and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through May 27, 2027 and lists Kathleen T Phillips, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1205557691
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameLEWIS & KLANCKE CARDIOLOGY, P.A.
Location Address780 DUNLAWTON AVE STE 101Port Orange, FL 32127-4252
Mailing Address695 N Clyde Morris BlvdDaytona Beach, FL 32114-2321 · (386) 258-8722 · Fax (386) 258-9443
Phone(386) 265-5926
Fax(386) 265-5928
Organization SubpartYesParent: Lewis & Klancke Caradiology, P.a.
Authorized OfficialKathleen T PhillipsCredentialing Coordinator · (386) 258-8722
Enumeration DateSeptember 6, 2022
Last NPPES UpdateOctober 3, 20232 updates tracked since enumeration
NPPES CertifiedOctober 3, 2023
✔ NPI 1205557691 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
780 DUNLAWTON AVE STE 101, Port Orange, FL 32127
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Other Names 1

Doing Business AsDaytona Heart Group

Other Identifiers 2

Other99279FL · Other
Medicaid119006900FL

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

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 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: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1205557691. It was assigned to this organization in the NPPES registry on September 6, 2022. 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 780 Dunlawton Ave Ste 101, Port Orange, FL 32127. The listed phone number is (386) 265-5926.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2059607) is associated with this NPI, valid through May 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 October 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.