Keith S Havemeyer, PT, OCS, FAAOMPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004663 Issued in CT

Practice address

550 Chase Ave
Waterbury, CT 06704-1904

Phone

(860) 250-4369

NPI assigned

Apr 10, 2007

Last updated

May 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Physical Therapy LLC.Group PAC ID 8022292911, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peak Physical Therapy LLC.

  • Rehabilitation Clinic/Center
  • Waterbury, CT
  • NPI 1730486804

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1720201932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CHASE AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041904",
            "telephone_number": "860-250-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CHASE AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041904",
            "telephone_number": "860-250-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVEMEYER",
        "first_name": "KEITH",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PT, OCS, FAAOMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "004663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Harvey
• Robert A Haswell, MSW,BA,LMSW
• Barbara A Hatch, LCSW
• Hatzalah of Waterbury, Inc.
• Samantha N Hauser, AUD
• Aneisha Hawthorne, BBA
• Kelly Hayden
• Carlin B Hayes
• George Hayes Jr., MSW
• Rachel Hayes, LPC

• Physical Therapist in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.