Active NPI
Patrick James Keohane, PHD
- Clinical Psychologist
- Fort Meade, SD
National Provider Identifier
1235221995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 380
- Practice address
- 113 Comanche Rd
Fort Meade, SD 57741-1002 - Phone
- (605) 720-7000
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 380 | SD | Primary |
Addresses
Primary practice location
113 Comanche Rd
Fort Meade, SD 57741-1002
Mailing address
113 Comanche Rd
Fort Meade, SD 57741-1002
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235221995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 COMANCHE RD",
"city": "FORT MEADE",
"state": "SD",
"postal_code": "577411002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 COMANCHE RD",
"city": "FORT MEADE",
"state": "SD",
"postal_code": "577411002",
"telephone_number": "605-720-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOHANE",
"first_name": "PATRICK",
"middle_name": "JAMES",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SD",
"license": "380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Meade, SD
Sources for this page
- 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.