Keith Bernard Marcantel, M.A., M.S., NCSP

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

1376967885 Issued in CO

Practice address

2802 N Nevada Ave
Colorado Springs, CO 80907-6201

Phone

(719) 471-4329

NPI assigned

Aug 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1487063244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N BALDWIN ST",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808631374",
            "telephone_number": "719-330-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076201",
            "telephone_number": "719-471-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCANTEL",
        "first_name": "KEITH",
        "middle_name": "BERNARD",
        "name_prefix": "Mr.",
        "credential": "M.A., M.S., NCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "CO",
            "license": "1376967885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMART SCHOOLS PARTNERS NPI NUMBER",
            "identifier": "1376967885",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMART SCHOOLS PARTNERS TYPE OF BUSINESS",
            "identifier": "251C00000X",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moana Mapu
• Melody Sun Mar, M.D.
• Eric Ryan Marable, MD
• Jennifer Kathryn Marable, PA-C
• Marc S Kelly MD PC
• Dianne C March, O.T.
• Peter James March
• Lauren Marchessault, CNM
• Anna Marchetti
• Alec John Marchitello, RBT

• Developmentally Disabled Services Day Training Agency in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Developmentally Disabled Services Day Training Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.