Keenan Reardon

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1700 E Oltorf St Ste 105
Austin, TX 78741-4379

Phone

(512) 652-0014

Fax

(737) 205-3194

NPI assigned

May 22, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, TX, AZ3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ati Holdings of Arizona, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1871570309
  Medicare reassignment Care Compare group NPD
• Ideal Physical Therapy of Texas LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Plano, TX
  • NPI 1538573746
  Medicare reassignment NPD
• Erhardt Physical Therapy and Sports Medicine, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Scappoose, OR
  • NPI 1326110313
  Medicare reassignment NPD
• Ideal Physical Therapy of Texas LLC

  • Durable Medical Equipment & Medical Supplies
  • Murphy, TX
  • NPI 1902773161
  NPD
• Ideal Rehabilitation LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1831353614
  NPD (past)

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1861231565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E OLTORF ST STE 105",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787414379",
            "telephone_number": "512-652-0014",
            "fax_number": "737-205-3194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3322 N Vancouver Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97227",
            "country_code": "US",
            "telephone_number": "503-200-6650",
            "fax_number": "503-205-0748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REARDON",
        "first_name": "KEENAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Realign Counseling & Psychological Services
• Megan Squibb Ream, LMSW
• Roy Scott Ream, M.D.
• Janice Ellen Reardon, D.D.S.
• Julie A Reardon, MD
• Shelly Michael Reardon, MD
• Donna L Reaves, LPC, LMFT
• Rhonda Rebecca Reavis, OT
• Brett Allen Rebal, M.D.
• Rebecca Pokluda, P.C. (KidWorks Therapy Services)

• Physical Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.