Zachary Keith, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2021033637 Issued in MO

Practice address

223 S Jefferson St
Ava, MO 65608

Phone

(417) 429-4693

Fax

(417) 753-7765

NPI assigned

Aug 24, 2021

Last updated

Sep 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Physical Therapy Specialist Clinic, Inc.

  • Physical Therapist
  • West Plains, MO
  • NPI 1659312619
  Medicare reassignment NPD

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1356018808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219297",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219297",
            "telephone_number": "417-429-4693",
            "fax_number": "417-753-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 S JEFFERSON ST",
            "city": "AVA",
            "state": "MO",
            "postal_code": "65608",
            "telephone_number": "417-429-4693",
            "fax_number": "417-753-7765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1206 N Main St",
            "address_purpose": "LOCATION",
            "city": "Mountain Grove",
            "state": "MO",
            "postal_code": "657111025",
            "country_code": "US",
            "telephone_number": "417-926-5699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEITH",
        "first_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2021033637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacinda Kaye Higley, LMT
• Micah Nicole Hubbard, APRN, FNP-C
• Rebecca L Johnson, APN
• Candace K Jones, MSW, LCSW
• Ida N Junge, FNP
• Sharon L Kelley, LCSW
• Youngmyong M Kim
• April Dawn Kimball, FNP
• Jordan Lynn King
• Judy King, LPC

• Physical Therapist in Ava, MO
• Providers in Ava, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.