Michael Paul Keenan, PT,DPT,ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT024089 Issued in PA

Practice address

110 Ardmore Ave Unit a
Ardmore, PA 19003-1339

Phone

(484) 498-8299

Fax

(484) 494-2938

NPI assigned

Dec 22, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Progress Physical Therapy LLC

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1164851085
  NPD (past)

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1679719645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412969",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412066",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ARDMORE AVE UNIT A",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190031339",
            "telephone_number": "484-498-8299",
            "fax_number": "484-494-2938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2129 W Oregon Ave",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191454131",
            "country_code": "US",
            "telephone_number": "215-336-6630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "PT,DPT,ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "070802068",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara G Fraiman DMD LLC
• Karen Berberian, L.L.C.
• Karen L. Abrams M.D. LLC
• Kay Daily Care LLC
• Chandra Angelena Kee, MD
• Desiree Keller
• Emily Kelly
• Marie Kiechel, DPT
• Frank H. King Jr., M.D.
• Brendan Kirby

• Physical Therapist in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.