NPIMap

Organization Active NPI

Keck Enterprises, LLC

  • Community Based Hospice Care Agency
  • Albuquerque, NM
National Provider Identifier
1063926806
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
3586 Issued in NM
Legal business name
KECK ENTERPRISES, LLC
Doing business as
Roadrunner Healthcare
Practice address
8300 Carmel Ave NE Ste 401
Albuquerque, NM 87122-3147
Phone
(505) 321-4819
Fax
(505) 898-3630
NPI assigned
Nov 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Jennifer Keck
Title
Manager
Phone
(505) 321-7295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 3586 NM Primary

Addresses

Primary practice location

8300 Carmel Ave NE Ste 401
Albuquerque, NM 87122-3147

Mailing address

PO Box 2046
Corrales, NM 87048-2046
Phone (505) 321-4819

Other identifiers 1

IdentifierTypeStateIssuer
3586OtherNMSTATE OF NEW MEXICO

Other names 1

  • Roadrunner Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181221002410 NM Part A Provider - Hospice 8527342559 Practice locations: Albuquerque, NM; Corrales, NM; Los Lunas, NM; Santa Fe, NM

Hospice certification: CCN 321576

Legal name
KECK ENTERPRISES LLC
Doing business as
ROADRUNNER HEALTHCARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 11, 2018
Last certification
Apr 14, 2022
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Enrollment address
8300 Carmel Ave NE
Ste 401
Albuquerque, NM 87122-3147

Care Compare: Hospice

Medicare Care Compare
Listed as
Roadrunner HealthcareCCN 321576 · All quality measures
Ownership
For-Profit
Certified
Oct 11, 2018
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

8300 Carmel Ave NE
Ste 401
Albuquerque, NM 87122
Phone (505) 321-4819

4940 Corrales Rd
Ste 150
Corrales, NM 87048
Phone (505) 250-8337

4940 Corrales Rd
Corrales, NM 87048
Phone (505) 897-3784

3600 Rodeo Ln
Ste D4
Santa Fe, NM 87507
Phone (505) 416-7095

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Catherine Rosacker Sharp LLC Organization, Albuquerque, NM LLC 5% Or Greater Direct Ownership Interest Jan 31, 2025 50%
Suzanne M Pinon Individual Contracted Managing EmployeeMD; Apr 9, 2021
Other Apr 9, 2021
Jennifer Keck Individual 5% Or Greater Direct Ownership Interest Jan 31, 2025 50%
Corporate OfficerManager Jan 31, 2025
Catherine Rosacker Sharp Individual 5% Or Greater Indirect Ownership Interest Jan 31, 2025 50%
Corporate OfficerManager Jan 31, 2025
W-2 Managing EmployeeAdministrator Sep 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1063926806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2046",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870482046",
            "telephone_number": "505-321-4819",
            "fax_number": "505-898-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CARMEL AVE NE STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223147",
            "telephone_number": "505-321-4819",
            "fax_number": "505-898-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KECK ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "KECK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "505-321-7295"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NM",
            "license": "3586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW MEXICO",
            "identifier": "3586",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roadrunner Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.