Individual provider Active NPI

Carrie Keith, DPT

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1306614359
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
09034R Issued in LA
Practice address
3100 Samford Ave
Shreveport, LA 71103-4239
Phone
(318) 222-5704
NPI assigned
Dec 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 09034R LA Primary

Addresses

Primary practice location

3100 Samford Ave
Shreveport, LA 71103-4239

Mailing address

251 Padgett Rd
Benton, LA 71006-8661
Phone (708) 772-1611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216001687 LA Practitioner - Physical Therapist in Private Practice 6406290501 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children Current Accepting new patients
Shriners Hospitals for Children CurrentSince Jan 14, 2024 Accepting new patients
Shriners Hospitals for Children CurrentSince Jan 14, 2024 Accepting new patients

Locations

3100 Samford Ave
Shreveport, LA 71103
Phone (318) 222-5704

Organizations & group practices 3

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": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1306614359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 PADGETT RD",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710068661",
            "telephone_number": "708-772-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SAMFORD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034239",
            "telephone_number": "318-222-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "CARRIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09034R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.