Shannon Nicole Keathley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT25745 Issued in FL

Practice address

860 Columbine Lea
Sevierville, TN 37862-6085

Phone

(865) 640-7040

NPI assigned

Aug 2, 2010

Sex

Female

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 FL

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 and National Provider Directory roles.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment NPD

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1427362417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 COLUMBINE LEA",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378626085",
            "telephone_number": "865-640-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 COLUMBINE LEA",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378626085",
            "telephone_number": "865-640-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATHLEY",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT25745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Tyler Justice, PHARM D.
• Kenneth Lee Justice, MD
• K VA T Food Stores Inc (Food City Pharmacy)
• K VA T Food Stores Inc (Food City Pharmacy #668)
• Sarah Kamp, NP
• Maggie Elline Keck, FNP
• Keeton Clinic PLLC
• Robert Wayne Keeton Jr., MD
• Kimberly D Kelly, RN
• Dana Nadine Partington Kembel, FNP-BC

• Physical Therapist in Sevierville, TN
• Providers in Sevierville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.