Individual provider Active NPI

Joanna M Keenan, PT

  • Physical Therapist
  • Columbus, OH
National Provider Identifier
1356676043
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
012300 Issued in OH
Practice address
1120 Polaris Pkwy
Suite 202
Columbus, OH 43240-4042
Phone
(614) 433-0264
Fax
(614) 545-0474
NPI assigned
Oct 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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 012300 OH Primary

Addresses

Primary practice location

1120 Polaris Pkwy
Suite 202
Columbus, OH 43240-4042

Mailing address

200 Putnam St
Suite 800
Marietta, OH 45750-3005
Phone (740) 373-9446

Other identifiers 1

IdentifierTypeStateIssuer
2073241MedicaidOH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012300OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1356676043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PUTNAM ST",
            "address_2": "SUITE 800",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503005",
            "telephone_number": "740-373-9446",
            "fax_number": "740-373-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 POLARIS PKWY",
            "address_2": "SUITE 202",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432404042",
            "telephone_number": "614-433-0264",
            "fax_number": "614-545-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "JOANNA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "012300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2073241",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.