Individual provider Active NPI

Kent Vincent Keyser, PT

  • Orthopedic Physical Therapist
  • Eugene, OR
National Provider Identifier
1659406882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1469 Issued in OR
Practice address
436 Charnelton St
Eugene, OR 97401-2626
Phone
(541) 344-6446
Fax
(541) 344-6336
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1469 OR Primary

Addresses

Primary practice location

436 Charnelton St
Eugene, OR 97401-2626

Mailing address

436 Charnelton St
Eugene, OR 97401-2626
Phone (541) 344-6446

Other identifiers 1

IdentifierTypeStateIssuer
J344602OtherORPACIFICSOURCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000857 OR Practitioner - Physical Therapist in Private Practice 8325032147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1469ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Physical Therapy, Inc. CurrentSince May 27, 2003 Accepting new patients

Locations

436 Charnelton St
Eugene, OR 97401
Phone (541) 344-6446

444 Charnelton St
Eugene, OR 97401
Phone (541) 344-6446

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659406882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CHARNELTON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012626",
            "telephone_number": "541-344-6446",
            "fax_number": "541-344-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CHARNELTON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012626",
            "telephone_number": "541-344-6446",
            "fax_number": "541-344-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYSER",
        "first_name": "KENT",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "1469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICSOURCE",
            "identifier": "J344602",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.