Individual provider Active NPI

Kelly McKeon, LMT

  • Massage Therapist
  • Lacey, WA
National Provider Identifier
1699269837
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60855605 Issued in WA
Practice address
8650 Martin Way E Ste 207
Lacey, WA 98516-6610
Phone
(360) 951-4504
Fax
(877) 848-7757
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60855605 WA Primary

Addresses

Primary practice location

8650 Martin Way E Ste 207
Lacey, WA 98516-6610

Mailing address

400 Cooper Point Rd SW #27 #12228
Olympia, WA 98502
Phone (360) 951-4504

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

LicenseStateTypeSpecialty
MA60855605WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David M. Warwick DC PLLC CurrentSince Mar 16, 2020 Accepting new patients

Locations

8650 Martin Way E
Ste 207
Lacey, WA 98516
Phone (360) 951-4504

400 Cooper Point Rd SW
Ste 27
Olympia, WA 98502

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1699269837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COOPER POINT RD SW #27 #12228",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98502",
            "telephone_number": "360-951-4504",
            "fax_number": "877-848-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8650 MARTIN WAY E STE 207",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985166610",
            "telephone_number": "360-951-4504",
            "fax_number": "877-848-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "KELLY",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60855605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.