Individual provider Active NPI

Keenia Tappin, MD

  • Pediatrics Physician
  • Madera, CA
National Provider Identifier
1043701378
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A165256 Issued in CA
Practice address
9300 Valley Childrens PL
Madera, CA 93636-8761
Phone
(559) 353-5174
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A165256 CA Primary

Addresses

Primary practice location

9300 Valley Childrens PL
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL
Madera, CA 93636-8761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220324002029 CA Practitioner - Pediatric Medicine 3072908219 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A165256CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health CurrentSince Dec 14, 2021 Accepting new patients
Camarena Health Pediatrics Current Accepting new patients
Camarena Health CurrentSince Dec 14, 2021 Accepting new patients
Valley Children'S Primary Care Group, Inc. Pediatrics Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients
Valley Children'S Medical Group Pediatrics Past Accepting new patients

Locations

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

Interoperability endpoints

  • Direct secure messaging: ktappin64810@valleychildrens-prd.direct-ci.com

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1043701378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPPIN",
        "first_name": "KEENIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A165256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.