Michaela Lee Keister, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.026695 Issued in IL

Practice address

209 9TH St
Rockford, IL 61104-2235

Phone

(779) 696-8318

NPI assigned

Jul 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michaela Lee Nelson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1548996002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 SALADINO DR",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739210",
            "telephone_number": "815-494-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 9TH ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042235",
            "telephone_number": "779-696-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISTER",
        "first_name": "MICHAELA",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.026695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAELA",
            "last_name": "NELSON",
            "middle_name": "LEE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kbclinic
• Tina Keen
• Matthew S. Keene, DPM
• Renee Lynn Keeney, CNM
• Valeria Lisa Kehoe, IBCLC, RLC, PMH-C
• John J Keith, MD
• Mary E Keller, M.D.
• Cynthia Kelling, APN
• Kelly a. Kalt, MSW, LCSW, Inc.
• Kelly J. Moore D.D.S., P.C.

• Physical Therapist in Rockford, IL
• Providers in Rockford, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.