Individual provider Active NPI

Johnathan L Keefe

  • Counselor
  • Winston-Salem, NC
National Provider Identifier
1598019473
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
8138 Issued in NC
Practice address
1959 N. Peace Haven Road
Suite 274
Winston-Salem, NC 27106
Phone
(336) 577-0469
Fax
(704) 939-1173
NPI assigned
Oct 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Counselor 101Y00000X 8138 NC Primary

Addresses

Primary practice location

1959 N. Peace Haven Road
Suite 274
Winston-Salem, NC 27106

Mailing address

1959 N. Peace Haven Road
Suite 274
Winston-Salem, NC 27106
Phone (336) 577-0469

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
8138NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1598019473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 N. PEACE HAVEN ROAD",
            "address_2": "SUITE 274",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-577-0469",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 N. PEACE HAVEN ROAD",
            "address_2": "SUITE 274",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-577-0469",
            "fax_number": "704-939-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "JOHNATHAN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "8138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.