Keystone Rehabilitation Systems Inc

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

KEYSTONE REHABILITATION SYSTEMS INC

Practice address

409 2ND Ave
Suite 202
Collegeville, PA 19426-3625

Phone

(610) 489-5772

Fax

(610) 454-7726

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael E Tarvin

Title

Vice President & Secretary

Phone

(717) 972-1100

Specialties & licenses 1

Addresses

Other names 1

• Keystone Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1417997206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 2ND AVE",
            "address_2": "SUITE 202",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263625",
            "telephone_number": "610-489-5772",
            "fax_number": "610-454-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE REHABILITATION SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Keystone Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Theresa Keeley
• Lauren Kelley
• Taylor Kelly
• Devin Kennedy, CRNP
• Nicole B Kesner
• Frederick Seungjoon Kim, DO
• Naomi Avoline Kim, MA, LPC
• Alexis Kingcade
• Jessica Kirk, M. ED
• Wasana Klayson

• Rehabilitation Clinic/Center in Collegeville, PA
• Providers in Collegeville, PA by specialty
• Rehabilitation Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.