Christine Mimick Keller, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

755 Issued in NE

Practice address

1401 W Michigan Ave
Norfolk, NE 68701-5644

Phone

(402) 371-8701

Fax

(402) 371-8704

NPI assigned

Nov 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Christine Marie Mimick Former name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spier Physical Therapy IncGroup PAC ID 8729049366, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spier Physical Therapy Inc

  • Physical Therapist
  • Norfolk, NE
  • NPI 1033202833
  Medicare reassignment Care Compare group NPD
• Pioneer Physical Therapy LTD PTR

  • Physical Therapist
  • Lincoln, NE
  • NPI 1134171291
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902976905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W MICHIGAN AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015644",
            "telephone_number": "402-371-8701",
            "fax_number": "402-371-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W MICHIGAN AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687015644",
            "telephone_number": "402-371-8701",
            "fax_number": "402-371-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "CHRISTINE",
        "middle_name": "MIMICK",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76058051000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "MIMICK",
            "middle_name": "MARIE",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Keifer
• Miranda Keifer, CHW, CNA
• David Joel Keleny, MD
• Matilda J Kell
• Lori M Kellen, BSW
• Connie Kelley
• Kelly Rose Kelley, PTA
• Skylar Jo Kelly, M.S. CF-SLP
• Danielle Denise Kennebeck
• Melinda Kathryn Kennel, O.D.

• Physical Therapist in Norfolk, NE
• Providers in Norfolk, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.