MEDICARE: DR. KEITH M LOOP BA, DSOM, JD, LBMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	2023	NC
2	171100000X	Acupuncturist	AC17725	CA
3	171100000X	Acupuncturist	AC180187	OR
4	225700000X	Massage Therapist	MT0000582	CO
5	225700000X	Massage Therapist	0019016277	VA
6	171100000X	Acupuncturist	0121000873	VA
7	171100000X	Acupuncturist	ACU0002336	CO
8	225700000X	Massage Therapist	19192	NC
9	225700000X	Massage Therapist	17539	OR

General Provider Information

NPI Number	:	1467700344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH M LOOP BA, DSOM, JD, LBMT

Provider Business Mailing Address
First Line	:	70 RETA RD
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730-8767
Country	:	US
Telephone Number	:	971-998-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 RETA RD
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730-8767
Country	:	US
Telephone Number	:	971-998-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2012
Last Update Date	:	04/15/2026

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