Active NPI
Amanda Edwards Keegan, MPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1245446103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5018
- Practice address
- 12616 SE Stark St BLDG L
Portland, OR 97233-1058 - Phone
- (360) 480-5859
- Fax
- (503) 408-0791
- NPI assigned
- May 15, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5018 | OR | Primary |
Addresses
Primary practice location
12616 SE Stark St BLDG L
Portland, OR 97233-1058
Mailing address
12616 SE Stark St BLDG L
Portland, OR 97233-1058
Phone (360) 480-5859
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 |
|---|---|---|---|
| 5018 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Namaste Natural Healing Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Naturopath
- Portland, OR
- NPI 1902953508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358121600000",
"number": "1245446103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12616 SE STARK ST BLDG L",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331058",
"telephone_number": "360-480-5859",
"fax_number": "503-408-0791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12616 SE STARK ST BLDG L",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331058",
"telephone_number": "360-480-5859",
"fax_number": "503-408-0791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEGAN",
"first_name": "AMANDA",
"middle_name": "EDWARDS",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2013-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "5018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.