Individual provider Active NPI

Kaitlyn Marie Keefer

  • Physical Therapist
  • Southern Pines, NC
National Provider Identifier
1902344401
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P17049 Issued in NC
Practice address
292 Commerce Ave
Southern Pines, NC 28387-7059
Phone
(910) 757-0408
NPI assigned
Feb 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT025793 PA
Physical Therapist 225100000X P17049 NC Primary

Addresses

Primary practice location

292 Commerce Ave
Southern Pines, NC 28387-7059

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

Other practice location 1

384 Middlecreek Rd
Rockwood, PA 15557-7312
Phone (814) 289-1763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170622002052 NC Practitioner - Physical Therapist in Private Practice 8527336171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

292 Commerce Ave
Southern Pines, NC 28387-7059
Phone (910) 757-0408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P17049NCMDPhysical Therapist
PT025793PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kinetic Institute Physical Therapy, Inc Physical Therapist CurrentSince Apr 13, 2017 Accepting new patients
Peak Performance Sports and Physical Therapy, LLC Physical Therapist CurrentSince Jun 2, 2025 Accepting new patients
Carolina Strong Physical Therapy, LLC Physical Therapist PastSince Apr 8, 2015 Accepting new patients

Locations

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

2009 Neuse Blvd
New Bern, NC 28560
Phone (252) 636-9800

730 S Horner Blvd
Sanford, NC 27330
Phone (984) 270-7063

1210 Carthage St
Sanford, NC 27330
Phone (919) 776-5488

292 Commerce Ave
Southern Pnes, NC 28387
Phone (910) 757-0408

4002 Executive Park Blvd
Ste 800
Southport, NC 28461
Phone (910) 357-5748

4355 NC Highway 211
#D
West End, NC 27376
Phone (910) 310-4850

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1902344401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 COMMERCE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877059",
            "telephone_number": "910-757-0408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "384 Middlecreek Rd",
            "address_purpose": "LOCATION",
            "city": "Rockwood",
            "state": "PA",
            "postal_code": "155577312",
            "country_code": "US",
            "telephone_number": "814-289-1763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-03",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT025793",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.