Individual provider Active NPI

Keenan Rhys McCune, L.M.T., C.A.

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1124318498
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
16130 Issued in OR
Practice address
3644 SW Troy St
Suite 200
Portland, OR 97219-1684
Phone
(503) 293-3001
NPI assigned
Apr 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 16130 OR Primary

Addresses

Primary practice location

3644 SW Troy St
Suite 200
Portland, OR 97219-1684

Mailing address

2409 NE MLK Blvd
Apt 308
Portland, OR 97212-3760
Phone (505) 980-2333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16130ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joyce D. McClure, D.C., P.C. Past Accepting new patients

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1124318498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 NE MLK BLVD",
            "address_2": "APT 308",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123760",
            "telephone_number": "505-980-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 SW TROY ST",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191684",
            "telephone_number": "503-293-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUNE",
        "first_name": "KEENAN",
        "middle_name": "RHYS",
        "credential": "L.M.T., C.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "16130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.