Active NPI
Matthew C. Keifer, MD
- Preventive Medicine/Occupational Environmental Medicine Physician
- Marshfield, WI
National Provider Identifier
1033209903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 55074
- Practice address
- 1000 N Oak Ave
Marshfield, WI 54449-5703 - Phone
- (715) 387-5511
- Fax
- (715) 387-5240
- NPI assigned
- Oct 13, 2006
- Last updated
- Apr 18, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00020882 | WA | |
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 55074 | WI | Primary |
Addresses
Primary practice location
1000 N Oak Ave
Marshfield, WI 54449-5703
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136695 | Other | WA | L & I |
| 911019392 | Other | COMMERCIAL | |
| 4597KE | Other | WA | REGENCE |
| 8602971 | Other | WA | CHPW |
| 8602971 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00020882 | WA | MD | Internal Medicine Physician |
| 55074 | WI | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1033209903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495703",
"telephone_number": "715-387-5511",
"fax_number": "715-387-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495703",
"telephone_number": "715-387-5511",
"fax_number": "715-387-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEIFER",
"first_name": "MATTHEW",
"middle_name": "C.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00020882",
"primary": false
},
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "WI",
"license": "55074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L & I",
"identifier": "136695",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "911019392",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "4597KE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHPW",
"identifier": "8602971",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8602971",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.