Individual provider Active NPI

Mitzi Keaton, OTR/L

  • Occupational Therapist
  • Marmet, WV
National Provider Identifier
1508034760
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1333 Issued in WV
Practice address
1 Sutphin Dr
Marmet, WV 25315-1977
Phone
(304) 949-1580
NPI assigned
Feb 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1333 WV Primary

Addresses

Primary practice location

1 Sutphin Dr
Marmet, WV 25315-1977

Mailing address

1 Sutphin Dr
Marmet, WV 25315-1977
Phone (304) 949-1580

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1508034760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SUTPHIN DR",
            "city": "MARMET",
            "state": "WV",
            "postal_code": "253151977",
            "telephone_number": "304-949-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SUTPHIN DR",
            "city": "MARMET",
            "state": "WV",
            "postal_code": "253151977",
            "telephone_number": "304-949-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATON",
        "first_name": "MITZI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marmet, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.