Krista Lee Keck, PT – Physical Therapist

Key facts

NPI: 1164575791
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 12522-24 (WI)
Practice address: 2345 Canterbury LN
Sister Bay, WI 54234-5602
Phone: (920) 854-4111
Fax: (920) 854-7807
NPI assigned: Jan 18, 2007
Sex: Female
Sole proprietor: No

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.

Door County Memorial Hospital Critical Access Hospital · Sturgeon Bay, WI · NPI 1093743874

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
12522-24	WI	MD	Physical Therapist

Practice roles

Organization	Specialty	Status	New patients
Door County Memorial Hospital		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	12522-24	WI	Yes

Addresses

Primary practice location

2345 Canterbury LN
Sister Bay, WI 54234-5602

Mailing address

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 746-0410

Other identifiers

Identifier	Type	State	Issuer
1164575791	Medicaid	WI

Other providers in Sister Bay, WI

All providers in Sister Bay, WI · Physical Therapist in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.