Individual provider Active NPI

Haley Keylon

  • Occupational Therapist
  • Elizabethton, TN
National Provider Identifier
1104595487
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7035 Issued in TN
Practice address
1660 Central Ave
Elizabethton, TN 37643-4850
Phone
(423) 647-2346
NPI assigned
Sep 9, 2021
Last updated
May 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 14391 NC
Occupational Therapist 225X00000X 0007845 CO
Occupational Therapist 225X00000X 7035 TN Primary

Addresses

Primary practice location

1660 Central Ave
Elizabethton, TN 37643-4850

Mailing address

1660 Central Ave
Elizabethton, TN 37643-4850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240227000748 NC Practitioner - Occupational Therapist in Private Practice 8325483639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

6215 N US 19E Hwy
C/O Cranberry House
Newland, NC 28657-9447
Phone (828) 270-4657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14391NCMDPublic Health Dentist
0007845COMDOccupational Therapist
7035TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 14, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Jan 14, 2024 Accepting new patients

Locations

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

6215 N US 19E Hwy
Newland, NC 28657
Phone (828) 270-4657

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

13681 S Highway 226
Spruce Pine, NC 28777
Phone (828) 270-7089

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1104595487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 CENTRAL AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376434850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 CENTRAL AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376434850",
            "telephone_number": "423-647-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYLON",
        "first_name": "HALEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14391",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0007845",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "7035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.