Individual provider Active NPI

Patricia McNeil, PT

  • Physical Therapist
  • Yucca, AZ
National Provider Identifier
1235309311
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8596 Issued in AZ
Practice address
11071 S. Camelback Road
Yucca, AZ 86438-0155
Phone
(928) 279-3652
Fax
(888) 446-5008
NPI assigned
Mar 5, 2008
Last updated
Mar 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501013680 MI
Physical Therapist 225100000X 8596 AZ Primary

Addresses

Primary practice location

11071 S. Camelback Road
Yucca, AZ 86438-0155

Mailing address

PO Box 155
Yucca, AZ 86438-0155
Phone (928) 279-3652

Other identifiers 1

IdentifierTypeStateIssuer
628701MedicaidAZ

Other names 1

  • Patricia Keeler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180105000428 AZ Practitioner - Physical Therapist in Private Practice 2466524053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8596AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Accomplished LLC Physical Therapist Current Accepting new patients
Agave Physical Therapy LLC CurrentSince Aug 1, 2017 Accepting new patients
Genesys Regional Medical Center Physical Therapist Past Accepting new patients

Locations

191 Swanson Ave
Ste 102
Lk Havasu Cty, AZ 86403
Phone (928) 855-7880

1990 McCulloch Blvd N
Ste D213
Lk Havasu Cty, AZ 86403

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1235309311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "YUCCA",
            "state": "AZ",
            "postal_code": "864380155",
            "telephone_number": "928-279-3652",
            "fax_number": "888-446-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11071 S. CAMELBACK ROAD",
            "city": "YUCCA",
            "state": "AZ",
            "postal_code": "864380155",
            "telephone_number": "928-279-3652",
            "fax_number": "888-446-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEIL",
        "first_name": "PATRICIA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013680",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "628701",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "KEELER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yucca, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.