Active NPI
Jean Keough
- Occupational Therapist
- Greenville, NC
National Provider Identifier
1912077264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 48521
- Practice address
- Children'S Developmental Services Agency - Dept of Ped
Irons Building - Oglesby Dr.
Greenville, NC 27858 - Phone
- (252) 737-1177
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 48521 | NC | Primary |
Addresses
Primary practice location
Children'S Developmental Services Agency - Dept of Ped
Irons Building - Oglesby Dr.
Greenville, NC 27858
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Phone (252) 744-3253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48521 | Other | NC | BCBS NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 48521 | NC | MD | Occupational Therapist |
NPI Registry JSON
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": "1912077264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069",
"telephone_number": "252-744-3253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CHILDREN'S DEVELOPMENTAL SERVICES AGENCY - DEPT OF PED",
"address_2": "IRONS BUILDING - OGLESBY DR.",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27858",
"telephone_number": "252-737-1177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOUGH",
"first_name": "JEAN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "48521",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "48521",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.