Individual provider Active NPI

Kathleen Marie Keefe, FNP-C

  • Family Nurse Practitioner
  • Elmira, NY
National Provider Identifier
1023216041
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F335177-1 Issued in NY
Practice address
602 Ivy St
2ND Floor
Elmira, NY 14905-1646
Phone
(607) 737-4130
Fax
(607) 271-2099
NPI assigned
Jul 11, 2007
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F335177-1 NY Primary

Addresses

Primary practice location

602 Ivy St
2ND Floor
Elmira, NY 14905-1646

Mailing address

722 W Water St
Elmira, NY 14905-2435
Phone (607) 271-2050

Other identifiers 2

IdentifierTypeStateIssuer
02950296MedicaidNY
102812947MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071114000169 NY Practitioner - Nurse Practitioner 3072601798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of ChemungGroup PAC ID 4688692874, 3 clinicians

Practice addresses (Care Compare)

103 Washington St
Elmira, NY 14901-3220
Phone (607) 737-2001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F335177-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Chemung Current Accepting new patients
County of Chemung CurrentSince Feb 2, 2022 Accepting new patients
Arnot Ogden Medical Center Past Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients

Locations

103 Washington St
Elmira, NY 14901
Phone (607) 737-2001

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1023216041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052435",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 IVY ST",
            "address_2": "2ND FLOOR",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051646",
            "telephone_number": "607-737-4130",
            "fax_number": "607-271-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335177-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02950296",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102812947",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.