Individual provider Active NPI

Keenan F Templeton, PA-C

  • Medical Physician Assistant
  • Evans, GA
National Provider Identifier
1225271547
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005566 Issued in GA
Practice address
1205 Town Park LN
Evans, GA 30809-3481
Phone
(706) 868-3100
Fax
(706) 228-3125
NPI assigned
Apr 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 005566 GA Primary

Addresses

Primary practice location

1205 Town Park LN
Evans, GA 30809-3481

Mailing address

1205 Town Park LN
Evans, GA 30809-3481
Phone (706) 868-3100

Other identifiers 1

IdentifierTypeStateIssuer
003128349BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091104000037 GA Practitioner - Physician Assistant 9638217185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical GroupGroup PAC ID 7719976521, 14 clinicians

Practice addresses (Care Compare)

1205 Town Park LN
Evans, GA 30809-3481
Phone (706) 868-3100

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005566GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Juanita G Trimor MD PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: keenan.templeton.1@7697.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1225271547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 TOWN PARK LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093481",
            "telephone_number": "706-868-3100",
            "fax_number": "706-228-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 TOWN PARK LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093481",
            "telephone_number": "706-868-3100",
            "fax_number": "706-228-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLETON",
        "first_name": "KEENAN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003128349B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.