Individual provider Active NPI

Casey-John Adrian Keyes, DO

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1093418139
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.082710 Issued in IL
Practice address
820 S Wood Street
MC 675
Chicago, IL 60612
Phone
(312) 996-2933
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125.082710 IL Primary

Addresses

Primary practice location

820 S Wood Street
MC 675
Chicago, IL 60612

Mailing address

60 Placitas Trails Rd
Placitas, NM 87043-9420
Phone (303) 242-1038

Other practice location 1

60 Placitas Trails Rd
Placitas, NM 87043-9420
Phone (303) 242-1038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230714001785 IL Order and Referring Only - Emergency MedicinePractitioner - Internal MedicinePractitioner - Emergency Medicine 1658731203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.082710ILMDEmergency Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ckeyes151045@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1093418139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PLACITAS TRAILS RD",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870439420",
            "telephone_number": "303-242-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S WOOD STREET",
            "address_2": "MC 675",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-2933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Placitas Trails Rd",
            "address_purpose": "LOCATION",
            "city": "Placitas",
            "state": "NM",
            "postal_code": "870439420",
            "country_code": "US",
            "telephone_number": "303-242-1038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEYES",
        "first_name": "CASEY-JOHN",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.082710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.