KEITH RAYMOND MATHERLY (NPI# 1871090191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871090191 |
| Entity Type | Individual |
| Full Name | KEITH RAYMOND MATHERLY |
| Credential | MASSAGE THERAPIST |
| Practice Address |
20000 Victor Pkwy Ste 100 Livonia MI 48152-7027 |
| Practice Telephone | 7349531745 |
| Practice Fax Number | 7349531743 |
| Mailing Telephone | 7349531745 |
| Mailing Fax Number | 7349531743 |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2018-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 7501000863 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
20000 VICTOR PKWY STE 100 |
| City | LIVONIA |
| State | MI |
| Zip Code | 48152-7027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366735136 | Jennifer Kileny | Speech-Language Pathologist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2011-05-26 |
| 1396346805 | Lauren Elizabeth Cook | Physical Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2020-11-03 |
| 1407465867 | Steven Lynn Brown | Physical Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2020-07-30 |
| 1780210435 | Christopher M Plague | Occupational Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2020-03-13 |
| 1184265068 | Tiyana Sidni King | Occupational Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2019-10-02 |
| 1306408844 | Charles Swingle | Physical Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2019-07-05 |
| 1629580261 | Megan Elizabeth Rotter | Occupational Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2017-11-03 |
| 1326560483 | Jessica Elyse Pulliam | Physical Therapist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2017-07-11 |
| 1265885875 | Emily Gold Coughlin | Physical Therapy Assistant | 20000 Victor Pkwy Ste 100, Livonia, MI 48152 | 2016-07-19 |
| 1942648209 | Andrea E Thomas | Speech-Language Pathologist | 20000 Victor Pkwy Ste 100, Livonia, MI 48152-7027 | 2013-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648171 | Hillary Fitzsimmons Psyd Pllc | Clinic/Center | 19455 Weyhar St, Livonia, MI 48152 | 2020-10-30 |
| 1639780968 | Goyanka Ranganathan | Student in an Organized Health Care Education/Training Program | Ipc Primary Care Internal Medicine, 37595 Seven Mile Road, Suite 340, Livonia, MI 48152 | 2020-08-11 |
| 1457988552 | Adam Ouellette | Student in an Organized Health Care Education/Training Program | St. Joe's Outpatient Psychiatry and Counseling Center, 37595 Seven Mile Rd, Suite 230, Livonia, MI 48152 | 2020-03-26 |
| 1972006047 | Genise Kerner Md PC | Clinic/Center | 37675 Pembrooke Ave, Livonia, MI 48152 | 2018-03-14 |
| 1205340593 | Rafal Hamamh | Dentist | 37595 7 Mile Rd Ste 4450, Livonia, MI 48152 | 2017-11-22 |
| 1053830489 | Felicia Cerise Reese | Registered Nurse | 17197 N. Laurel Park Drive, 555, Livonia, MI 48152 | 2017-09-18 |
| 1164943882 | Muhammad Yasir | Student in an Organized Health Care Education/Training Program | 37595 Seven Mile Rd. #340, Livonia, MI 48152 | 2017-07-03 |
| 1184154544 | St Mary Mercy Physician Practices | Clinic/Center | 39201 7 Mile Rd Bldg Room140, Livonia, MI 48152 | 2017-06-18 |
| 1912437518 | Divonne Touch | Clinic/Center | 18298 Middlebelt, Liviona, MI 48152 | 2017-06-15 |
| 1861922445 | Cheryl Lang | Physical Therapist | 17177 N Laurel Park Drive, Suite 417, Livonia, MI 48152 | 2017-06-15 |
| Find all providers in zip 48152 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654922 | Evelyn Barker | Massage Therapist | 38221 Plymouth Rd # 11, Livonia, MI 48150-1051 | 2020-09-18 |
| 1275008989 | Aegis Health Perspectives, Inc. | Massage Therapist | 38019 Schoolcraft Rd, Livonia, MI 48150-1065 | 2018-10-09 |
| 1790139574 | Kimberly Parsons-bala | Massage Therapist | 10902 Farmington Rd, Livonia, MI 48150-2753 | 2016-04-19 |
| 1841668076 | Kathleen Priami - Gorman | Massage Therapist | 18294 Gillman St, Livonia, MI 48152-3722 | 2015-09-03 |
| 1700261864 | Lauryn Hahn | Massage Therapist | 14531 Garden St, Livonia, MI 48154-4001 | 2015-07-29 |
| 1447635248 | Jessica Frances Saban | Massage Therapist | 29471 Morlock St, Livonia, MI 48152-1865 | 2015-07-22 |
| 1679836217 | Dawn Donnelly | Massage Therapist | 29548 Trancrest St, Livonia, MI 48152-3468 | 2012-06-19 |
| 1003177411 | Amy Deshano | Massage Therapist | 33655 Pondview Cir, Livonia, MI 48152-1471 | 2012-06-01 |
| 1225301286 | A1 Marketing Force, LLC | Massage Therapist | 38910 Minton Ave, Livonia, MI 48150-3322 | 2012-02-21 |
| 1407134216 | Michele Haynes | Massage Therapist | 15208 Berwick St, Livonia, MI 48154-3554 | 2011-07-27 |
| Find all providers in LIVONIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.