Organization Active NPI

Keehn Chiropractic Clinic

  • Chiropractor
  • Marysville, WA
National Provider Identifier
1114126182
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
600424793 Issued in WA
Legal business name
KEEHN CHIROPRACTIC CLINIC
Practice address
1241 State Ave Ste 101
Marysville, WA 98270-3612
Phone
(360) 659-8411
Fax
(360) 658-1033
NPI assigned
Jul 11, 2007
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Dr. Stephen Richard Keehn, D.C.NPI 1770641730
Title
Owner/President
Phone
(360) 659-8411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 600424793 WA Primary

Addresses

Primary practice location

1241 State Ave Ste 101
Marysville, WA 98270-3612

Mailing address

1241 State Ave Ste 101
Marysville, WA 98270-3612
Phone (360) 659-8411

Other identifiers 1

IdentifierTypeStateIssuer
0201599OtherWADEPARTMENT OF LABOR AND I

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000515 WA Part B Supplier - Clinic/Group Practice 0547158529 Receives reassigned benefits from 1 practitioner
Practice locations: Marysville, WA

National Provider Directory

National Provider Directory

Locations

1241 State Ave
Ste 101
Marysville, WA 98270
Phone (360) 650-8411

505 Cedar Ave
Ste C3
Marysville, WA 98270
Phone (360) 659-8411

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1114126182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 STATE AVE STE 101",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703612",
            "telephone_number": "360-659-8411",
            "fax_number": "360-658-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 STATE AVE STE 101",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703612",
            "telephone_number": "360-659-8411",
            "fax_number": "360-658-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEEHN CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "KEEHN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "360-659-8411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "600424793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND I",
            "identifier": "0201599",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.