Active NPI
Jillian Keenan
- Speech-Language Pathologist
- Wellsville, NY
National Provider Identifier
1609333020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 028432-1
- Practice address
- 50 School St
Wellsville, NY 14895-1631 - Phone
- (585) 596-2170
- NPI assigned
- Feb 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 028432-1 | NY | Primary |
Addresses
Primary practice location
50 School St
Wellsville, NY 14895-1631
Mailing address
2833 Hillcrest Dr
Wellsville, NY 14895-9314
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
| License | State | Type | Specialty |
|---|---|---|---|
| 028432-1 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1609333020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2833 HILLCREST DR",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148959314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 SCHOOL ST",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148951631",
"telephone_number": "585-596-2170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENAN",
"first_name": "JILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-21",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "028432-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wellsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.