Keaton Overton

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10781 Issued in TN

Practice address

1700 W Market St Ste Fandg
Bolivar, TN 38008-1653

Phone

(731) 658-2206

NPI assigned

Aug 30, 2019

Last updated

Aug 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: keaton.overton.1@1366.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Star Physical Therapy LP

  • Rehabilitation Clinic/Center
  • Bolivar, TN
  • NPI 1417404351
  NPD (past)
• Suncoast Retina Consultants, LLC

  dba The Macula Center

  • Ophthalmology Physician
  • Hudson, FL
  • NPI 1730233388
  NPD (past)

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1346898590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W MARKET ST STE FANDG",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081653",
            "telephone_number": "731-658-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "KEATON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029723",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sylvestor D. Nicol, M.D.
• Felix Chukwudi Nnaji, MD
• Nuckolls Drug Stores, Inc (Medical Arts Pharmacy)
• Nuckolls Drug Stores, Inc (Hudson Drug Store)
• James Kim Nuckolls, BS
• Nithyananda Pakkala, M.D.
• Hope Caples Parker
• Anita Jo Parks, D.D.S.
• Chelsey Elizabeth Parks, NP
• Leslie Parnell, P.T.A.

• Physical Therapist in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.