TIMOTHY LYNN KEENEN (NPI# 1194716571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194716571 |
| Entity Type | Individual |
| Full Name | TIMOTHY LYNN KEENEN |
| Credential | MD |
| Practice Address |
19260 Sw 65th Ave Ste 270 Tualatin OR 97062 |
| Mailing Address |
19260 Sw 65th Ave Suite 270 Tualatin OR 97062-5701 |
| Practice Telephone | 5038859391 |
| Practice Fax Number | 5035635520 |
| Mailing Telephone | 5038859391 |
| Mailing Fax Number | 5035635520 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2018-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MD15842 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 215608 | 05 | |
| MEDICARE PTAN | R113019 | 01 |
| Street Address |
19260 SW 65TH AVE STE 270 |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639160369 | Tana Marie Haynes | Internal Medicine | 19260 Sw 65th Ave Ste 270, Suite B2, Tualatin, OR 97062-5705 | 2005-11-02 |
| 1194343640 | Emily Ann Geyen | Physician Assistant | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062-5705 | 2020-07-10 |
| 1932232741 | Northwest Internal Medicine LLC | Specialist | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062-5705 | 2007-03-13 |
| 1740311679 | Pacific Spine Specialists, LLC | Specialist | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062-5705 | 2007-03-09 |
| 1003807884 | Lisa Mae Cowan | Physician Assistant | 19260 Sw 65th Ave Ste 270, Tualatin, OR 97062 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942702642 | Robert L Tatsumi Md PC | Orthopaedic Surgery | 19255 Sw 65th Ave Ste 200, Tualatin, OR 97062-9712 | 2018-03-08 |
| 1376972182 | Oregon Spine Care LLC | Orthopaedic Surgery | 19255 Sw 65th Ave, Suite 200, Tualatin, OR 97062-7451 | 2013-11-02 |
| 1992828800 | Robert Tatsumi | Orthopaedic Surgery | 19255 Sw 65th Ave Ste 220, Tualatin, OR 97062-9717 | 2007-04-06 |
| 1437192036 | Mark Cecil Weston | Orthopaedic Surgery | 19255 Sw 65th Ave, Suite 110, Tualatin, OR 97062-7451 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932607215 | Spine Cin of Oregon LLC | Orthopaedic Surgery | 1867 Williams Hwy Ste 287, Grants Pass, OR 97527-5854 | 2018-01-31 |
| 1023516309 | Joint Replacement Cin of Oregon LLC | Orthopaedic Surgery | 1867 Williams Hwy Ste 288, Grants Pass, OR 97527-5856 | 2018-01-31 |
| 1912349580 | Southern Oregon Spine Care, P.C. | Orthopaedic Surgery | 1311 Barnett Road Ste 201, Medford, OR 97504 | 2013-07-24 |
| 1063722262 | Centennial Medical Group North, LLC | Orthopaedic Surgery | 2801 Nw Mercy Dr Ste 340, Roseburg, OR 97471-2348 | 2010-10-21 |
| 1295779734 | Todd Jay Lewis | Orthopaedic Surgery | 2211 Nw Professional Dr, Ste 100, Corvallis, OR 97330-3887 | 2006-06-15 |
| 1699763607 | Mark Delano Peterson | Orthopaedic Surgery | 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 | 2005-10-12 |
| 1548722614 | Sor Care of Or, LLC | Orthopaedic Surgery | 1867 Williams Hwy Ste 287, Grants Pass, OR 97527-5854 | 2019-04-05 |
| 1043605454 | Michael Wheeler | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2015-04-02 |
| 1700203338 | Renuka Reddy Kuruvalli | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Orthopaedic and Rehabilitaion Department, Portland, OR 97239-3011 | 2014-03-20 |
| 1164860193 | Satoshi Kawaguchi | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Op31, Portland, OR 97239-3011 | 2013-06-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on TIMOTHY LYNN KEENEN.
| 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.