Active NPI
John Mackenzie Keenan, D.C.
- Chiropractor
- Watertown, NY
National Provider Identifier
1699944744
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(14) exclusion effective Nov 20, 2008.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X005776-1
- Practice address
- 718 Leray St
Watertown, NY 13601-1311 - Phone
- (315) 788-5433
- Fax
- (315) 788-5433
- NPI assigned
- Feb 22, 2008
- Last updated
- Feb 22, 2008
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X005776-1 | NY | Primary |
Addresses
Primary practice location
718 Leray St
Watertown, NY 13601-1311
Mailing address
718 Leray St
Watertown, NY 13601-1311
Phone (315) 788-5433
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X005776-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203638400000",
"number": "1699944744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 LERAY ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011311",
"telephone_number": "315-788-5433",
"fax_number": "315-788-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 LERAY ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136011311",
"telephone_number": "315-788-5433",
"fax_number": "315-788-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENAN",
"first_name": "JOHN",
"middle_name": "MACKENZIE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-22",
"last_updated": "2008-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X005776-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.