Active NPI
Charles Keenan, DPT
- Physical Therapist
- Brandon, FL
National Provider Identifier
1689265738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT36521
- Practice address
- 1320 Oakfield Dr
Brandon, FL 33511-4860 - Phone
- (813) 607-6880
- NPI assigned
- Feb 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT36521 | FL | Primary |
Addresses
Primary practice location
1320 Oakfield Dr
Brandon, FL 33511-4860
Mailing address
8416 Del Largo Circle
104
Tampa, FL 33614
Phone (740) 317-3597
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT36521 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rewire | Current | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Tampa, FL
- NPI 1619621935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1689265738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8416 DEL LARGO CIRCLE",
"address_2": "104",
"city": "TAMPA",
"state": "FL",
"postal_code": "33614",
"telephone_number": "740-317-3597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 OAKFIELD DR",
"city": "BRANDON",
"state": "FL",
"postal_code": "335114860",
"telephone_number": "813-607-6880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENAN",
"first_name": "CHARLES",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-01",
"last_updated": "2021-02-01",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT36521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.