Jacob Keary, AT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2601002465 Issued in MI

Practice address

799 N Hewitt Rd
Ypsilanti, MI 48197-1701

Phone

(785) 312-0294

NPI assigned

Feb 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1831656339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 ARBOR CIR W APT 103",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481973453",
            "telephone_number": "785-312-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 N HEWITT RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971701",
            "telephone_number": "785-312-0294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Chalk Hill Ct",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "KS",
            "postal_code": "660493004",
            "country_code": "US",
            "telephone_number": "785-312-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEARY",
        "first_name": "JACOB",
        "credential": "AT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-21",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601002465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Kavanaugh
• Maryann Ogechukwu Kayode
• Elyssa Kayser, MD
• Farwa Hasan Kazmi, MD
• Barbara A Keane, RN
• Margaret Nicole Keedy
• Jennifer Eve Keene, PA
• Quentavia Keene
• Kristie Lynn Keeton, MD
• Thomas E Kehn, M.D.

• Athletic Trainer in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.