Individual provider Active NPI

Susan M Keith, MD

  • Internal Medicine Physician
  • Wilmington, DE
National Provider Identifier
1013968130
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C10004619 Issued in DE
Practice address
1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone
(302) 633-5302
Fax
(302) 633-5582
NPI assigned
May 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C10004619 DE Primary

Addresses

Primary practice location

1601 Kirkwood Hwy
Wilmington, DE 19805-4917

Mailing address

1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Phone (302) 633-5302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130705000389 DE Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9234379751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C10004619DEMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1013968130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-633-5302",
            "fax_number": "302-633-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KIRKWOOD HWY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054917",
            "telephone_number": "302-633-5302",
            "fax_number": "302-633-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10004619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.