{"npi":"1861491961","type":"NPI-1","status":"active","name":{"display":"Mr. Kenneth Klare Lpt","other":[],"first":"KENNETH","last":"KLARE","middle":"WADE","credential":"LPT"},"specialty":{"primary_taxonomy":"225100000X","primary_taxonomy_description":"Physical Therapist","slug":"physical-therapist","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":true,"state":"TX","license":"1096576"}]},"addresses":[{"purpose":"LOCATION","street_1":"702 E MIMOSA ST","city":"ROCKPORT","state":"TX","postal_code":"783824151","country_code":"US","phone":"3617298838","fax":"3617299508"},{"purpose":"MAILING","street_1":"702 E MIMOSA ST","city":"ROCKPORT","state":"TX","postal_code":"783824151","country_code":"US","phone":"3617298838","fax":"3617299508"}],"license":{"state":"TX","number":"1096576"},"identifiers":[{"type_code":"01","label":"Other","value":"7019083","state":"TX","issuer":"AETNA HEALTHCARE"},{"type_code":"05","label":"Medicaid","value":"0632119-01","state":"TN","issuer":null},{"type_code":"01","label":"Other","value":"83755T","state":"TX","issuer":"BCBS OF TEXAS"},{"type_code":"01","label":"Other","value":"6400153","state":"TX","issuer":"UNITED HEALTHCARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20120125000110","type_code":"14-65","type_desc":"PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE","state":"TX","pac_id":"1254508757"}]},"enumeration_date":"2005-07-20","last_updated":"2012-04-05","_meta":{"source":"NPPES","snapshot_date":"2012-04-05","doc_url":"https://findmynpi.com/api"}}