Kent Allen Keithly, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3690 Issued in OK

Practice address

522 W Broadway Ave
Enid, OK 73701-3842

Phone

(580) 237-0905

Fax

(580) 237-0948

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1821032699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 N 30TH ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737016864",
            "telephone_number": "580-237-6847",
            "fax_number": "580-237-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W BROADWAY AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013842",
            "telephone_number": "580-237-0905",
            "fax_number": "580-237-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITHLY",
        "first_name": "KENT",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "3690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00327766",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Nicole Kausek, LCSW
• KD Chiropractic
• Madelyn M Keck, A.R.N.P.
• Keithly Rehab PLLC
• Alice Keithly
• Paige Susanna Keithly, PH.D.
• Tiffany A Keitz, S.L.P.
• David Edward Keller, M.D.
• Lauren Keller
• Austin Kelly

• Physical Therapist in Enid, OK
• Providers in Enid, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.