Active NPI
Keegan Martin, DPT
- Physical Therapist
- Crescent City, CA
National Provider Identifier
1952834715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT292918
- Practice address
- 800 E Washington Blvd
Crescent City, CA 95531-8359 - Phone
- (707) 464-8511
- NPI assigned
- Apr 9, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT292918 | CA | Primary |
Addresses
Primary practice location
800 E Washington Blvd
Crescent City, CA 95531-8359
Mailing address
333 N Ash St
Bethel, OH 45106-1005
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 |
|---|---|---|---|
| PT292918 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491696000000",
"number": "1952834715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N ASH ST",
"city": "BETHEL",
"state": "OH",
"postal_code": "451061005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E WASHINGTON BLVD",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955318359",
"telephone_number": "707-464-8511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KEEGAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-09",
"last_updated": "2017-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT292918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.