Keyanna Debose, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP017326T Issued in MO

Practice address

6264 Lewis Dr Ste 100
Parkville, MO 64152-3603

Phone

(816) 587-8001

NPI assigned

Sep 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sage Physical Therapy & Wellness LLC

  • Physical Therapy Clinic/Center
  • Cambridge, MD
  • NPI 1467757575

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1760105845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 ABBOTT ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275363023",
            "telephone_number": "913-605-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6264 LEWIS DR STE 100",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "641523603",
            "telephone_number": "816-587-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOSE",
        "first_name": "KEYANNA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1107197",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP011884T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "CP015406T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21339",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "CP017326T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Davis, PLPC
• Jefferson E Davis, LSCSW, LCSW
• Mikayla Ann Davis
• Abigail Dawn Day
• Alison Taylor De Jong, MT-BC, RBT
• Morgan Elizabeth Demoss
• George Dent III, PH.D.
• Hailey Denton
• Joseph Michael Dicapo, RPH
• Anthony Dewayne Dishman

• Physical Therapist in Parkville, MO
• Providers in Parkville, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.