Active NPI
James Patrick Keeley, CTRS
- Recreation Therapist
- Martinez, CA
National Provider Identifier
1417694373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 69295
- Practice address
- 150 Muir Rd RM 103
Martinez, CA 94553-4668 - Phone
- (925) 804-1706
- NPI assigned
- May 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 69295 | CA | Primary |
Addresses
Primary practice location
150 Muir Rd RM 103
Martinez, CA 94553-4668
Mailing address
253 Redstone Cir
Suisun City, CA 94585-6312
Phone (650) 384-1669
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
| License | State | Type | Specialty |
|---|---|---|---|
| 69295 | CA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1417694373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "253 REDSTONE CIR",
"city": "SUISUN CITY",
"state": "CA",
"postal_code": "945856312",
"telephone_number": "650-384-1669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 MUIR RD RM 103",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534668",
"telephone_number": "925-804-1706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEELEY",
"first_name": "JAMES",
"middle_name": "PATRICK",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-12",
"last_updated": "2022-05-12",
"certification_date": "2022-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "CA",
"license": "69295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.