Keenan Carson
Individual provider Active NPI Occupational Therapist · Birmingham, AL
NPI 1710696935 · NPPES record last updated Nov 16, 2022
Key facts
- NPI
- 1710696935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 4416 (AL)
- Practice address
- 1972 Huntington LN
Birmingham, AL 35214-4877 - Phone
- (205) 335-0644
- NPI assigned
- Nov 16, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4416 | AL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 4416 | AL | Yes |
Addresses
Primary practice location
1972 Huntington LN
Birmingham, AL 35214-4877
Mailing address
1972 Huntington LN
Birmingham, AL 35214-4877
Phone (205) 335-0644
NPI Registry JSON
{
"created_epoch": "1668556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1710696935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1972 HUNTINGTON LN",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352144877",
"telephone_number": "205-335-0644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1972 HUNTINGTON LN",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352144877",
"telephone_number": "205-335-0644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARSON",
"first_name": "KEENAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-16",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "4416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
- William R Carroll
- Courtney Pratt Carruba
- Olivia Smith Carruth
- Danielle Carson
- Jeremy Carson
- Meagan Carson
- William Carson
- Latoya M Carstarphen
- Emily Cartee
- Carter Consulting, Corp
All providers in Birmingham, AL · Occupational Therapist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.