Active NPI
Keith Bacon Ritchie, P.A.
- Physician Assistant
- South Yarmouth, MA
National Provider Identifier
1104390921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1613
- Practice address
- 76 Pleasant St
South Yarmouth, MA 02664-4547 - Phone
- (508) 760-5318
- NPI assigned
- Jan 15, 2019
- Last updated
- Jan 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1613 | MA | Primary |
Addresses
Primary practice location
76 Pleasant St
South Yarmouth, MA 02664-4547
Mailing address
76 Pleasant St
South Yarmouth, MA 02664-4547
Phone (508) 760-5318
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1613 | MA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1104390921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 PLEASANT ST",
"city": "SOUTH YARMOUTH",
"state": "MA",
"postal_code": "026644547",
"telephone_number": "508-760-5318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 PLEASANT ST",
"city": "SOUTH YARMOUTH",
"state": "MA",
"postal_code": "026644547",
"telephone_number": "508-760-5318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RITCHIE",
"first_name": "KEITH",
"middle_name": "BACON",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA1613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Yarmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.