Active NPI
Keaton T Yearwood, P.T., DPT
- Physical Therapist
- Toccoa, GA
National Provider Identifier
1013366152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012355
- Practice address
- 22 Hayes St
Toccoa, GA 30577-2696 - Phone
- (706) 886-3883
- Fax
- (706) 886-3812
- NPI assigned
- Jun 9, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012355 | GA | Primary |
Addresses
Primary practice location
22 Hayes St
Toccoa, GA 30577-2696
Mailing address
22 Hayes St
PO Box 399
Toccoa, GA 30577-2696
Phone (706) 886-3883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT012355 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465430400000",
"number": "1013366152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 HAYES ST",
"address_2": "PO BOX 399",
"city": "TOCCOA",
"state": "GA",
"postal_code": "305772696",
"telephone_number": "706-886-3883",
"fax_number": "706-886-3812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 HAYES ST",
"city": "TOCCOA",
"state": "GA",
"postal_code": "305772696",
"telephone_number": "706-886-3883",
"fax_number": "706-886-3812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEARWOOD",
"first_name": "KEATON",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "P.T., DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-09",
"last_updated": "2016-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT012355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toccoa, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.