Organization Active NPI

Keeney Theracare Services and Enterprises

  • Speech-Language Pathologist
  • Modesto, CA
National Provider Identifier
1528496403
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
13753 Issued in CA
Legal business name
KEENEY THERACARE SERVICES AND ENTERPRISES
Practice address
5225 Pentecost Dr
Suite 26
Modesto, CA 95356-9284
Phone
(209) 576-7280
Fax
(209) 576-7275
NPI assigned
Oct 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Authorized official

Name
Erin Kaye Keeney, M.S.NPI 1235373887
Title
Clinical Director
Phone
(209) 576-7280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 13753 CA Primary

Addresses

Primary practice location

5225 Pentecost Dr
Suite 26
Modesto, CA 95356-9284

Mailing address

5225 Pentecost Dr
Suite 26
Modesto, CA 95356-9284
Phone (209) 576-7280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140424001358 CA Part B Supplier - Clinic/Group Practice 5395978571 Receives reassigned benefits from 1 practitioner
Practice locations: Modesto, CA

National Provider Directory

National Provider Directory

Locations

5225 Pentecost Dr
Ste 26
Modesto, CA 95356
Phone (209) 576-7275

1729 Tully Rd
Ste 5
Modesto, CA 95350
Phone (209) 576-7280

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383177600000",
    "number": "1528496403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 PENTECOST DR",
            "address_2": "SUITE 26",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569284",
            "telephone_number": "209-576-7280",
            "fax_number": "209-576-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 PENTECOST DR",
            "address_2": "SUITE 26",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569284",
            "telephone_number": "209-576-7280",
            "fax_number": "209-576-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEENEY THERACARE SERVICES AND ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-31",
        "last_updated": "2013-10-31",
        "status": "A",
        "authorized_official_last_name": "KEENEY",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "209-576-7280",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "13753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.