Individual provider Active NPI

Erin Kaye Keeney, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Modesto, CA
National Provider Identifier
1235373887
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
13753 Issued in CA
Practice address
5225 Pentecost Dr
Suite 26
Modesto, CA 95356-9284
Phone
(209) 576-7280
Fax
(209) 576-7275
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 13753 CA Primary

Addresses

Primary practice location

5225 Pentecost Dr
Suite 26
Modesto, CA 95356-9284

Mailing address

5225 Pentecost Dr
Suite 26
Modesto, CA 95356-9284
Phone (209) 576-7280

Other identifiers 1

IdentifierTypeStateIssuer
13753OtherCACA STATE LICENSE TO PRACTICE SPEECH PATHOLOGY FROM THE CA DEPT. OF CONSMER AFFAI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100608000685 CA Practitioner - Qualified Speech Language Pathologist 7416087010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1729 Tully Rd
Suite 5
Modesto, CA 95350-4081
Phone (209) 576-7280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
California Theracare Services Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1235373887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 PENTECOST DR",
            "address_2": "SUITE 26",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569284",
            "telephone_number": "209-576-7280",
            "fax_number": "209-576-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 PENTECOST DR",
            "address_2": "SUITE 26",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569284",
            "telephone_number": "209-576-7280",
            "fax_number": "209-576-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENEY",
        "first_name": "ERIN",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE TO PRACTICE SPEECH PATHOLOGY FROM THE CA DEPT. OF CONSMER AFFAI",
            "identifier": "13753",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.