Active NPI
Diane Keeven, P. T.
- Physical Therapist
- Saint Peters, MO
National Provider Identifier
1417909052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00939
- Practice address
- 4800 Mexico Rd
Suite 104
St Peters, MO 63376-1666 - Phone
- (636) 939-9540
- Fax
- (636) 939-9886
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00939 | MO | Primary |
Addresses
Primary practice location
4800 Mexico Rd
Suite 104
St Peters, MO 63376-1666
Mailing address
2454 W Clay St
Saint Charles, MO 63301-2548
Phone (636) 916-4625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00824752 | Other | MO | RAILROAD MEDICARE |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Babar Enterprises LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Excel Sports and Physical Therapy
- Physical Therapist
- Warrenton, MO
- NPI 1548425002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1417909052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2454 W CLAY ST",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012548",
"telephone_number": "636-916-4625",
"fax_number": "636-916-4628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 MEXICO RD",
"address_2": "SUITE 104",
"city": "ST PETERS",
"state": "MO",
"postal_code": "633761666",
"telephone_number": "636-939-9540",
"fax_number": "636-939-9886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEVEN",
"first_name": "DIANE",
"credential": "P. T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "00939",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00824752",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.