Individual provider Active NPI

Shenna R Keene, MD

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1063407039
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101238312 Issued in VA
Practice address
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone
(804) 791-8793
NPI assigned
Sep 15, 2005
Last updated
Jun 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101238312 VA Primary

Addresses

Primary practice location

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Mailing address

1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone (804) 791-8793

Other identifiers 2

IdentifierTypeStateIssuer
C06115OtherVAGROUP PTAN
C06695OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200522002153 VA Order and Referring Only - Family PracticePractitioner - Family Practice 0042242174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101238312VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Memorial Regional Medical Center Past Accepting new patients
Choptank Community Health System Inc PastSince Jan 1, 1990 Accepting new patients
Harness Health Pharmacy - Central Pharmacy Services LLC Past Accepting new patients
Choptank Community Health System Inc PastSince Jan 1, 1990 Accepting new patients
Bon Secours Memorial Regional Medical Center Inc Family Medicine Past Accepting new patients
Choptank Community Health System Inc PastSince Jan 1, 1990 Accepting new patients
Petersburg Clinic Company LLC Family Medicine Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1063407039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-791-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-791-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENE",
        "first_name": "SHENNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06115",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.