Individual provider Active NPI

Audrey Rebecca Keim, PT, DPT

  • Physical Therapist
  • Kearney, NE
National Provider Identifier
1780425280
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4650 Issued in NE
Practice address
2707 2ND Ave Ste B
Kearney, NE 68847-4401
Phone
(308) 234-1278
Fax
(308) 234-1279
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4650 NE Primary

Addresses

Primary practice location

2707 2ND Ave Ste B
Kearney, NE 68847-4401

Mailing address

PO Box 5285
Grand Island, NE 68802-5285
Phone (308) 675-1853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705000051 NE Practitioner - Physical Therapist in Private Practice 0244774982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Go Physical Therapy LLCGroup PAC ID 0749258994, 98 clinicians

Practice addresses (Care Compare)

2707 2ND Ave
Suite B
Kearney, NE 68847-4401
Phone (308) 234-1278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4650NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Go Physical Therapy, LLC Physical Therapist CurrentSince Jun 17, 2024 Accepting new patients

Locations

620 N Diers Ave
Ste 300
Grand Island, NE 68803
Phone (308) 382-0344

2714 2nd Ave
Ste A
Kearney, NE 68847
Phone (308) 236-7016

2707 2nd Ave
Ste B
Kearney, NE 68847
Phone (308) 234-1278

3219 Central Ave
Ste 105
Kearney, NE 68847
Phone (308) 865-2370

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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1780425280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5285",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025285",
            "telephone_number": "308-675-1853",
            "fax_number": "308-210-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 2ND AVE STE B",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688474401",
            "telephone_number": "308-234-1278",
            "fax_number": "308-234-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIM",
        "first_name": "AUDREY",
        "middle_name": "REBECCA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.