Keith James Haviland, D.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24039 Issued in CA

Practice address

8120 Baymist Dr #B
Huntington Beach, CA 92646

Phone

(714) 655-8511

NPI assigned

Aug 5, 2010

Last updated

Aug 5, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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.

• Patriot Physical Therapy

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1841074101
  Medicare reassignment NPD

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1932413507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 BAYMIST DR #B",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 BAYMIST DR #B",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92646",
            "telephone_number": "714-655-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILAND",
        "first_name": "KEITH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.P.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "24039",
            "primary": true
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": "CA",
            "license": "24039",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "24039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Lauren Hasen
• Paul Hans Hasenyager, PT
• Misty Hastings
• Annette Hatala, O.T.
• Elena Haub, O.T
• Aetina A Hawthorne
• Nancy Tomomi Hayata, DPM
• Cynthia Lynn Hayden
• Lynn Perryman Haye, PH.D.
• Vincent Paul Hayes, D.C.

• Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.