Individual provider Active NPI

Kevin O. Keown, M.D.

  • Family Medicine Physician
  • Baxley, GA
National Provider Identifier
1083606800
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29897 Issued in GA
Practice address
118 Azalea Rd Ste 1
Baxley, GA 31513-9197
Phone
(912) 294-0380
Fax
(912) 427-0591
NPI assigned
Aug 18, 2005
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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 29897 GA Primary

Addresses

Primary practice location

118 Azalea Rd Ste 1
Baxley, GA 31513-9197

Mailing address

118 Azalea Rd Ste 1
Baxley, GA 31513-9197
Phone (912) 294-0380

Other identifiers 1

IdentifierTypeStateIssuer
00349489AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20071010000404 GA Practitioner - Family PracticePractitioner - Emergency Medicine 1658467428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yurhealth LLCGroup PAC ID 6901263151, 7 clinicians

Practice addresses (Care Compare)

162 Jekyll Rd
Baxley, GA 31513-1175
Phone (478) 401-0477

330 Peachtree St
Suite 1
Jesup, GA 31545-0248
Phone 9124276964225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29897GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Family Practice Associates, P.C. Family Medicine CurrentSince Aug 5, 1987 Accepting new patients

Locations

118 Azalea Rd
Ste 1
Baxley, GA 31513
Phone (912) 294-0380

330 Peachtree St
Jesup, GA 31545
Phone (912) 415-8552

330 Peachtree St
Ste 1
Jesup, GA 31545
Phone (912) 427-6964

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFJBDD/Endpoint/CFJBDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBIBDD/Endpoint/FBIBDD

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1083606800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 AZALEA RD STE 1",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315139197",
            "telephone_number": "912-294-0380",
            "fax_number": "912-427-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 AZALEA RD STE 1",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315139197",
            "telephone_number": "912-294-0380",
            "fax_number": "912-427-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOWN",
        "first_name": "KEVIN",
        "middle_name": "O.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "29897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00349489A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxley, GA

Sources for this page

Verify at the official NPI Registry.