Individual provider Active NPI

Vincent Patrick Keeney, PA-C

  • Physician Assistant
  • Rocky Mount, NC
National Provider Identifier
1972900157
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05455 Issued in NC
Practice address
110 Patrick CT
Rocky Mount, NC 27804-8755
Phone
(252) 443-0400
Fax
(252) 443-0572
NPI assigned
Dec 3, 2014
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MED-PAC-LIC-62848 MT
Physician Assistant 363A00000X 0010-05455 NC Primary

Addresses

Primary practice location

110 Patrick CT
Rocky Mount, NC 27804-8755

Mailing address

110 Patrick CT
Rocky Mount, NC 27804-8755
Phone (252) 443-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150310001148 NC Practitioner - Physician Assistant 0941526990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

110 Patrick CT
Rocky Mount, NC 27804-1743
Phone 2524430400239

2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.29 of 100Reported as group
Quality
66.88
Promoting interoperability
97
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Regional Orthopaedics, PA CurrentSince Jun 1, 2024 Accepting new patients

Locations

110 Patrick Ct
Rocky Mount, NC 27804
Phone (252) 443-0400

2906 N Main St
Tarboro, NC 27886
Phone (252) 443-0400

Interoperability endpoints

  • Direct secure messaging: vincent.keeney.1@6545.direct.athenahealth.com

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1972900157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PATRICK CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048755",
            "telephone_number": "252-443-0400",
            "fax_number": "252-443-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PATRICK CT",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048755",
            "telephone_number": "252-443-0400",
            "fax_number": "252-443-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENEY",
        "first_name": "VINCENT",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-03",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-62848",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.