Individual provider Active NPI

Keith Monroe, PSY.D.

  • Exercise & Sports Psychologist
  • Augusta, GA
National Provider Identifier
1285619502
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exercise & Sports PsychologistTaxonomy code 103TE1100X
License
2903 Issued in GA
Practice address
One Freedom Way
Augusta, GA 30904-6285
Phone
(706) 733-0188
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2903 GA
Clinical Child & Adolescent Psychologist 103TC2200X 2903 GA
Exercise & Sports Psychologist 103TE1100X 2903 GA Primary
Psychologist 103T00000X 2903 GA
Rehabilitation Psychologist 103TR0400X 2903 GA

Addresses

Primary practice location

One Freedom Way
Augusta, GA 30904-6285

Mailing address

One Freedom Way
Augusta, GA 30904-6285
Phone (706) 733-0188

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

LicenseStateTypeSpecialty
2903GAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285619502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046285",
            "telephone_number": "706-733-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046285",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "2903",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "2903",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "GA",
            "license": "2903",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "2903",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "GA",
            "license": "2903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.