Active NPI
Tod Dempsey Keam, O.T.R.
- Occupational Therapist
- Lake Havasu City, AZ
National Provider Identifier
1790980407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2368
- Practice address
- 101 Civic Center LN
Lake Havasu City, AZ 86403-5607 - Phone
- (928) 855-8185
- NPI assigned
- Jun 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2368 | AZ | Primary |
Addresses
Primary practice location
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Mailing address
158 Resorter LN
Lake Havasu City, AZ 86406-6125
Phone (928) 505-8589
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2368 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790980407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 RESORTER LN",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864066125",
"telephone_number": "928-505-8589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CIVIC CENTER LN",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035607",
"telephone_number": "928-855-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEAM",
"first_name": "TOD",
"middle_name": "DEMPSEY",
"name_prefix": "Mr.",
"credential": "O.T.R.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "2368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.