Individual provider Active NPI

Tammy Lynn Keatts, MPT

  • Physical Therapist
  • Annapolis, MD
National Provider Identifier
1962581355
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19581 Issued in MD
Practice address
2001 Tidewater Colony Drive
Suite 102
Annapolis, MD 21401-2592
Phone
(410) 266-8010
Fax
(443) 782-2498
NPI assigned
Nov 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19581 MD Primary

Addresses

Primary practice location

2001 Tidewater Colony Drive
Suite 102
Annapolis, MD 21401-2592

Mailing address

2001 Tidewater Colony Drive
Suite 102
Annapolis, MD 21401-2592
Phone (410) 266-8010

Other identifiers 4

IdentifierTypeStateIssuer
371442OtherMDMAMSI HEALTH CARE
407373800MedicaidMD
61023404OtherMDMARYLAND CAREFIRST BLUE
S4410006OtherMDCAREFIRST BLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040921001129 MD Practitioner - Physical Therapist in Private Practice 7517935190 Reassigns benefits to 1 organization
I20260604001641 DC Practitioner - Physical Therapist in Private Practice 7517935190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2122 Autumn Haze CT
Gambrills, MD 21054-1912

PO Box
Suite 290609
Nashville, TN 37229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19581MDMDPhysical Therapist

Organizations & group practices 2

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": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1962581355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 TIDEWATER COLONY DRIVE",
            "address_2": "SUITE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012592",
            "telephone_number": "410-266-8010",
            "fax_number": "443-782-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 TIDEWATER COLONY DRIVE",
            "address_2": "SUITE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012592",
            "telephone_number": "410-266-8010",
            "fax_number": "443-782-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATTS",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-04",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI HEALTH CARE",
            "identifier": "371442",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407373800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND CAREFIRST BLUE",
            "identifier": "61023404",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CHOICE",
            "identifier": "S4410006",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.