Bryan Keck

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00317200 Issued in NJ

Practice address

1919 Greentree Rd Ste B
Cherry Hill, NJ 08003-1115

Phone

(856) 424-0993

NPI assigned

Dec 20, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ipta Clinical, LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
  • NPI 1760764484
  NPD (past)
• Specialized Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Cherry Hill, NJ
  • NPI 1225019805
  NPD (past)

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

{
    "created_epoch": "1450569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450569600000",
    "number": "1588029441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GRANDE BLVD",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080751351",
            "telephone_number": "610-442-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 GREENTREE RD STE B",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031115",
            "telephone_number": "856-424-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-20",
        "last_updated": "2015-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00317200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyse Kutsop Kay, OTR/L
• Shahin Kazemi, DDS
• Janet Keane, MPT
• Jessica Emily Kearns, DPT
• Katherine Keating, PT, DPT
• Jacqueline C Keefauver, PT, DPT
• Erin C Keefe, OT
• Cheryl Ann Keegan, PHARMD
• Patricia Keegan, MA, BCBA
• Brianna Keeler

• Physical Therapy Assistant in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2015; 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.