Individual provider Active NPI

Timothy Jacob Keyes Jr., D.C.

  • Chiropractor
  • Solon, OH
National Provider Identifier
1609883339
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3639 Issued in OH
Practice address
6175 Som Center Road
Suite 140
Solon, OH 44139-2941
Phone
(440) 248-5070
Fax
(440) 498-4620
NPI assigned
Aug 2, 2006
Last updated
Oct 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3639 OH Primary

Addresses

Primary practice location

6175 Som Center Road
Suite 140
Solon, OH 44139-2941

Mailing address

6175 Som Center Road
Suite 140
Solon, OH 44139-2941
Phone (440) 248-5070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000545 OH Practitioner - Chiropractic 8325045024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy J Keyes Jr DC LLCGroup PAC ID 6406853100, 2 clinicians

Practice addresses (Care Compare)

30775 Bainbridge Rd
Suite 170
Solon, OH 44139-2266
Phone (440) 600-2209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3639OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy J Keyes Jr DC LLC Chiropractor CurrentSince Aug 17, 2006 Accepting new patients

Locations

5231 Mayfield Rd
Lyndhurst, OH 44124
Phone (440) 442-5990

30775 Bainbridge Rd
Ste 170
Solon, OH 44139
Phone (440) 600-2209

6175 Som Center Rd
Ste 140
Solon, OH 44139
Phone (440) 248-5070

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1609883339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 SOM CENTER ROAD",
            "address_2": "SUITE 140",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392941",
            "telephone_number": "440-248-5070",
            "fax_number": "440-498-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 SOM CENTER ROAD",
            "address_2": "SUITE 140",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392941",
            "telephone_number": "440-248-5070",
            "fax_number": "440-498-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYES",
        "first_name": "TIMOTHY",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.