Phillip Keck, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810005353 Issued in VA

Practice address

1630 Wilkes Ridge Pkwy
Ste 105
Richmond, VA 23233-7460

Phone

(804) 270-7262

Fax

(804) 270-7264

NPI assigned

Jan 13, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Nurocoach Medical Group PLLC

  • Psychiatry Physician
  • Sugar Land, TX
  • NPI 1083332845
  Medicare reassignment
• Feel Better Global LLC

  • Durable Medical Equipment & Medical Supplies
  • Richmond, VA
  • NPI 1760209621
  NPD (past)
• Physical Medicine Associates LTD

  • Clinical Laboratory Director (Non-physician)
  • Columbia, MD
  • NPI 1750840666
  NPD (past)

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1083070536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD EXECUTIVE PLAZA 1",
            "address_2": "STE 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031",
            "telephone_number": "703-738-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 WILKES RIDGE PKWY",
            "address_2": "STE 105",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232337460",
            "telephone_number": "804-270-7262",
            "fax_number": "804-270-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810005353",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "VA",
            "license": "0810005353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkeck@spineandpain.emadirect.md",
            "affiliation": "N",
            "address_1": "1630 WILKES RIDGE PKWY",
            "address_2": "STE 105",
            "city": "RICHMOND",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232337460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Casey Keating, D.D.S.
• Michael Keaveny, PSY.D.
• Nyesha A. Keawmanee, M.S., CCC-SLP
• Basma Kebaish, DPT
• Manaye Kebede, MD
• Anne West Keeler, RD
• Christopher D Keeler, MSPT ATC
• Patti Jo D'Innocenzo Keeler, PTA
• Jared Wayne Keeley, PH.D.
• Stephanie Ann Keen-Pilecki, OT

• Psychologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.