Timothy Lynn Keenen, MD

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

MD15842 Issued in OR

Practice address

19260 SW 65TH Ave Ste 270
Tualatin, OR 97062

Phone

(503) 885-9391

Fax

(503) 563-5520

NPI assigned

Nov 3, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1194716571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE",
            "address_2": "SUITE 270",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970625701",
            "telephone_number": "503-885-9391",
            "fax_number": "503-563-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE STE 270",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "97062",
            "telephone_number": "503-885-9391",
            "fax_number": "503-563-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENEN",
        "first_name": "TIMOTHY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OR",
            "license": "MD15842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R113019",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215608",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark J Kaseweter, LPTA
• Caden Katada
• Robin Sean Kates, MD
• Shawna Day Kauffman, LMT
• Racquel Cherie Kavanaugh
• Sheri Lynn Kellams
• Dorothy M Kelling, RN
• Jennifer Suzanne Kelly, MD
• Nathan Arthur Kemalyan, M.D.
• Eric Kendall, PT, DPT

• Orthopaedic Surgery of the Spine Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Orthopaedic Surgery of the Spine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.