Individual provider Active NPI

Donell Jean Keddy, D.C

  • Chiropractor
  • Carthage, NY
National Provider Identifier
1023052966
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
011217 Issued in NY
Practice address
850 State St
Carthage, NY 13619-1429
Phone
(315) 493-2225
Fax
(315) 493-2224
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 011217-1 NY
Chiropractor 111N00000X 011217 NY Primary

Addresses

Primary practice location

850 State St
Carthage, NY 13619-1429

Mailing address

850 State Street
Carthage, NY 13619
Phone (315) 493-2225

Other names 1

  • Donell Jean Wright Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120529000035 NY Practitioner - Chiropractic 9032372230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan a Keddy DC PCGroup PAC ID 6406868603, 2 clinicians

Practice addresses (Care Compare)

137 E Main St
Suite 5
Gouverneur, NY 13642-1427
Phone (315) 287-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011217NYMDChiropractor
011217-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan a. Keddy D.C, P.C Chiropractor CurrentSince Jul 1, 2012 Accepting new patients

Locations

850 State St
Carthage, NY 13619
Phone (315) 493-2225

137 E Main St
Ste 5
Gouverneur, NY 13642
Phone (315) 287-2400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1023052966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 STATE STREET",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "13619",
            "telephone_number": "315-493-2225",
            "fax_number": "153-493-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 STATE ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191429",
            "telephone_number": "315-493-2225",
            "fax_number": "315-493-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDDY",
        "first_name": "DONELL",
        "middle_name": "JEAN",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-08-07",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011217-1",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONELL",
            "last_name": "WRIGHT",
            "middle_name": "JEAN",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carthage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.