Individual provider Active NPI

Colton Keener, PA

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1336653740
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110838 Issued in FL
Practice address
1050 SE Monterey Rd Ste 302
Stuart, FL 34994-4512
Phone
(772) 210-2447
NPI assigned
Nov 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA067397 PA
Physician Assistant 363A00000X PA9110838 FL Primary

Addresses

Primary practice location

1050 SE Monterey Rd Ste 302
Stuart, FL 34994-4512

Mailing address

1050 SE Monterey Rd Ste 302
Stuart, FL 34994-4512
Phone (772) 210-2447

Other practice location 1

2030 Thistle Hill Dr Ste 202
Spring Grove, PA 17362-1161
Phone (717) 791-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171228001794 FL Practitioner - Physician Assistant 6406114214 Reassigns benefits to 1 organization
I20260414003751 PA Practitioner - Physician Assistant 6406114214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

2030 Thistle Hill Dr
Suite 202
Spring Grove, PA 17362-1161
Phone (717) 843-7348

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110838FLMDPhysician Assistant
MA067397PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Surgery and Endoscopy Centers LLC CurrentSince Dec 1, 2024 Accepting new patients
Pinnacle Health Medical Services Physician Assistant Past Accepting new patients

Locations

1026 SE Federal Hwy
Stuart, FL 34994
Phone (772) 210-2447

325 Avenue B NW
Winter Haven, FL 33881
Phone (800) 364-9216

Interoperability endpoints

  • Direct secure messaging: colton.keener.1@30104.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1336653740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 302",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-210-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SE MONTEREY RD STE 302",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944512",
            "telephone_number": "772-210-2447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Thistle Hill Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Spring Grove",
            "state": "PA",
            "postal_code": "173621161",
            "country_code": "US",
            "telephone_number": "717-791-2520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENER",
        "first_name": "COLTON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA067397",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.