Individual provider Active NPI

Michael John Keeton, PA-C

  • Medical Physician Assistant
  • Lancaster, PA
National Provider Identifier
1073635652
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA 001667-L Issued in PA
Practice address
241 Rohrerstown Rd
Lancaster, PA 17603-2230
Phone
(717) 431-1770
Fax
(717) 431-0470
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA 001667-L PA Primary

Addresses

Primary practice location

241 Rohrerstown Rd
Lancaster, PA 17603-2230

Mailing address

48 W Governor Rd
Hershey, PA 17033-1722
Phone (717) 443-5172

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA 001667-LPAMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073635652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 W GOVERNOR RD",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170331722",
            "telephone_number": "717-443-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 ROHRERSTOWN RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032230",
            "telephone_number": "717-431-1770",
            "fax_number": "717-431-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETON",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA 001667-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.