Kathleen Keaton Hubbard, PTA

Primary specialty

SpecialistTaxonomy code 174400000X

License

116158 Issued in MO

Practice address

513 E Capri Dr
Bonne Terre, MO 63628-9331

Phone

(573) 358-7356

Fax

(573) 358-7356

NPI assigned

Aug 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Ann Keaton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1770775819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 E CAPRI DR",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636289331",
            "telephone_number": "573-358-7356",
            "fax_number": "573-358-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 E CAPRI DR",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636289331",
            "telephone_number": "573-358-7356",
            "fax_number": "573-358-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "KATHLEEN",
        "middle_name": "KEATON",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "116158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "KEATON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Michelle Hills, PHARMD
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• Bali Rae Hoover-Richardson, LPC
• Mandy Howard
• Charles Allen Hubbard, PT
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• Mary Suzanne Jones, FNP-BC
• Meggan Jones
• Andrea Kahn, MS CCC-SLP
• Kingdom United Education Incorporated

• Specialist in Bonne Terre, MO
• Providers in Bonne Terre, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.