Individual provider Active NPI

Paul Edward McKean, MPT

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1902092729
Registry record updated Sep 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305202166 Issued in VA
Practice address
12330 Ashton Mill Ter
Glen Allen, VA 23059-5486
Phone
(804) 249-3267
NPI assigned
Sep 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2007

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 2305202166 VA Primary

Addresses

Primary practice location

12330 Ashton Mill Ter
Glen Allen, VA 23059-5486

Mailing address

12330 Ashton Mill Ter
Glen Allen, VA 23059-5486
Phone (804) 249-3267

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

LicenseStateTypeSpecialty
2305202166VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189900800000",
    "number": "1902092729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12330 ASHTON MILL TER",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595486",
            "telephone_number": "804-249-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 ASHTON MILL TER",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595486",
            "telephone_number": "804-249-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEAN",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-16",
        "last_updated": "2007-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

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

Verify at the official NPI Registry.