Active NPI
Keith P Zettlemoyer, MSPT
- Physical Therapist
- Elizabethtown, PA
National Provider Identifier
1497773626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT018188
- Practice address
- 1070 Dairy LN
Elizabethtown, PA 17022-9547 - Phone
- (717) 361-7489
- Fax
- (717) 361-7528
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- 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 | PT018188 | PA | Primary |
Addresses
Primary practice location
1070 Dairy LN
Elizabethtown, PA 17022-9547
Mailing address
75 Evelyn Dr
Millersburg, PA 17061-1258
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT018188 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1497773626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 EVELYN DR",
"city": "MILLERSBURG",
"state": "PA",
"postal_code": "170611258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 DAIRY LN",
"city": "ELIZABETHTOWN",
"state": "PA",
"postal_code": "170229547",
"telephone_number": "717-361-7489",
"fax_number": "717-361-7528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZETTLEMOYER",
"first_name": "KEITH",
"middle_name": "P",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT018188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.