Stephanie Ann Keener, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.006497RX Issued in OH

Practice address

36 N Detroit St Ste 105
Xenia, OH 45385-2963

Phone

(937) 610-4673

NPI assigned

Oct 27, 2020

Sex

Female

Sole proprietor

Yes

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Decoach Team LLCGroup PAC ID 7517244551, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Decoach Team LLC

  dba DeCoach Rehabilitation Centre

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  Medicare reassignment Care Compare group
• Decoach Team LLC

  dba DeCoach Rehabilitation Centre

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1023618428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628",
            "fax_number": "513-737-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N DETROIT ST STE 105",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852963",
            "telephone_number": "937-610-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9505 Montgomery Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452427248",
            "country_code": "US",
            "telephone_number": "513-815-3667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Dayton St Unit 106",
            "address_purpose": "LOCATION",
            "city": "Yellow Springs",
            "state": "OH",
            "postal_code": "453871778",
            "country_code": "US",
            "telephone_number": "937-767-1088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENER",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.006497RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Michael Karhan
• Laura Ndip Katte, NP
• Kevin M Kearney, RD,LP
• William Keeler, CDCA
• Sandra Keen, LSW
• Douglas M Keeton
• Nicole Keeton
• Jason Kegley, CDCA
• Matthew Kelch
• Jenna Morgan Kelley, Q.B.H.S

• Medical Physician Assistant in Xenia, OH
• Providers in Xenia, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.