Active NPI
Todd Patrick Keanan, RKT
- Kinesiotherapist
- Tampa, FL
National Provider Identifier
1689619827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- License
- 1709
- Practice address
- 13000 Bruce B Downs Blvd
Tampa, FL 33612-4745 - Phone
- (813) 972-2000
- Fax
- (813) 979-3611
- NPI assigned
- Jun 20, 2006
- 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 |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | 1709 | IL | Primary |
Addresses
Primary practice location
13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Mailing address
2910 W San Rafael St
Tampa, FL 33629-6023
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 |
|---|---|---|---|
| 1709 | IL | MD | Kinesiotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689619827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 W SAN RAFAEL ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336296023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13000 BRUCE B DOWNS BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336124745",
"telephone_number": "813-972-2000",
"fax_number": "813-979-3611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEANAN",
"first_name": "TODD",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "RKT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": "IL",
"license": "1709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.