Active NPI
Robert William Keaton, PA - C
- Physician Assistant
- Rock Creek, OH
National Provider Identifier
1295012409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2618
- Practice address
- 2863 RT 45
Rock Creek, OH 44084-0298 - Phone
- (440) 563-3400
- NPI assigned
- Nov 16, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2618 | OH | Primary |
Addresses
Primary practice location
2863 RT 45
Rock Creek, OH 44084-0298
Mailing address
3125 Hallock Young Rd SW
Warren, OH 44481-9216
Phone (330) 824-3205
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2618 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1295012409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 HALLOCK YOUNG RD SW",
"city": "WARREN",
"state": "OH",
"postal_code": "444819216",
"telephone_number": "330-824-3205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2863 RT 45",
"city": "ROCK CREEK",
"state": "OH",
"postal_code": "440840298",
"telephone_number": "440-563-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEATON",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"credential": "PA - C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-16",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "2618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Creek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.