Mark A Keisel, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3793 Issued in NC

Practice address

100 East Rhode Island Ave. Ext.
Southern Pines, NC 28387

Phone

(910) 692-0371

Fax

(910) 692-0346

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154442952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 BUCKLER AVE.",
            "city": "ABERDEEN",
            "state": "NC",
            "postal_code": "28315",
            "telephone_number": "757-268-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAST RHODE ISLAND AVE. EXT.",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "28387",
            "telephone_number": "910-692-0371",
            "fax_number": "910-692-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISEL",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Kandes, FNP-C
• Pamela Geertgens Kantorowski, MD
• Michelle J Kaydo, MPT
• Alexandra Kilraine Kaznowski, PA-C
• Kaitlyn Marie Keefer
• Kendall Reid Olvey
• Raegan Janet Kennedy, RBT
• Karin Yount Kent, M.D.
• Kids' Residential Services, Inc.
• Kidzcare Pediatrics, PC

• Physical Therapy Assistant in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.