Provider Demographics
NPI:1114981800
Name:HEALTHKEEPERZ OUTPATIENT PHYSICAL REHAB.
Entity Type:Organization
Organization Name:HEALTHKEEPERZ OUTPATIENT PHYSICAL REHAB.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:BSPT
Authorized Official - Phone:910-522-1016
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1030
Mailing Address - Country:US
Mailing Address - Phone:910-522-1016
Mailing Address - Fax:910-521-4722
Practice Address - Street 1:209 W 3RD ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8768
Practice Address - Country:US
Practice Address - Phone:910-522-1016
Practice Address - Fax:910-521-4722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1709225100000X
NC1903225100000X
NC2053225100000X
NC5002225X00000X
NC6141235Z00000X
NC6132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211898Medicaid
NC017KCOtherBLUE CROSS BLUE SHIELD
NC5673158OtherFIRST HEALTH
NC7211898Medicaid