Individual provider Active NPI

Monica Deleah Keen, MS, ORT/L

  • Occupational Therapist
  • Goose Creek, SC
National Provider Identifier
1770674012
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
518 Issued in SC
Practice address
105 Galsworthy Dr
Goose Creek, SC 29445-7025
Phone
(843) 345-6402
Fax
(843) 569-0550
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 518 SC Primary

Addresses

Primary practice location

105 Galsworthy Dr
Goose Creek, SC 29445-7025

Mailing address

105 Galsworthy Dr
Goose Creek, SC 29445-7025
Phone (843) 345-6402

Other identifiers 1

IdentifierTypeStateIssuer
TH0074MedicaidSC

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
518SCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Developing Abilities Children'S Therapy Services PastSince Jul 24, 2022 Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1770674012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GALSWORTHY DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457025",
            "telephone_number": "843-345-6402",
            "fax_number": "843-569-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GALSWORTHY DR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457025",
            "telephone_number": "843-345-6402",
            "fax_number": "843-569-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "MONICA",
        "middle_name": "DELEAH",
        "name_prefix": "Ms.",
        "credential": "MS, ORT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH0074",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.