Active NPI
Randy Keck
- Home Modifications Contractor
- Pottstown, PA
National Provider Identifier
1235605338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- PA096084
- Practice address
- 931 Catfish LN
Pottstown, PA 19465-7305 - Phone
- (484) 366-4022
- NPI assigned
- Oct 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | PA096084 | PA | Primary |
Addresses
Primary practice location
931 Catfish LN
Pottstown, PA 19465-7305
Mailing address
931 Catfish LN
Pottstown, PA 19465-7305
Phone (484) 366-4022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1028954670003 | Medicaid | PA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA096084 | PA | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1235605338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 CATFISH LN",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194657305",
"telephone_number": "484-366-4022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "931 CATFISH LN",
"city": "POTTSTOWN",
"state": "PA",
"postal_code": "194657305",
"telephone_number": "484-366-4022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KECK",
"first_name": "RANDY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-17",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "PA",
"license": "PA096084",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1028954670003",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pottstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.