Keith A Tebbe, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

120 Coleman'S Crossing Blvd.
Marysville, OH 43040

Phone

(937) 578-7841

NPI assigned

Sep 17, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1003149345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LONDON AVE",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430405512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 COLEMAN'S CROSSING BLVD.",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "43040",
            "telephone_number": "937-578-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBBE",
        "first_name": "KEITH",
        "middle_name": "A",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-17",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Marie Sutton, MSW, LSW
• Synergy Medical, LLC
• Callie Tackett, PHARMD, RPH
• David A Tanner, DO
• Janet M Tate, RN
• Monica Vora Tejani, D.O.
• The Kroger Co
• The Main Quest Counseling
• The Marysville Union
• The Marysville Union Clubhouse

• Athletic Trainer in Marysville, OH
• Providers in Marysville, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.