Individual provider Active NPI

Barbara Ann Aug Keefe, D.P.T

  • Physical Therapist
  • Spooner, WI
National Provider Identifier
1508996190
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4364024 Issued in WI
Practice address
1280 Chandler Dr
Spooner, WI 54801-2202
Phone
(715) 635-2111
Fax
(715) 939-1557
NPI assigned
Mar 6, 2007
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4364024 WI Primary

Addresses

Primary practice location

1280 Chandler Dr
Spooner, WI 54801-2202

Mailing address

N3528 Caldwell Rd
Shell Lake, WI 54871-8788
Phone (715) 645-2198

Other identifiers 1

IdentifierTypeStateIssuer
40364400MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
4364024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1508996190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3528 CALDWELL RD",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548718788",
            "telephone_number": "715-645-2198",
            "fax_number": "715-939-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 CHANDLER DR",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548012202",
            "telephone_number": "715-635-2111",
            "fax_number": "715-939-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "BARBARA",
        "middle_name": "ANN AUG",
        "name_prefix": "Mrs.",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4364024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40364400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spooner, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.