Active NPI
Julian F Keith III, M.D.
- Neonatal-Perinatal Medicine Physician
- Redding, CA
National Provider Identifier
1104850668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- G64431
- Practice address
- 2175 Rosaline Ave
Redding, CA 96001-2509 - Phone
- (530) 225-7386
- Fax
- (530) 225-7266
- NPI assigned
- Jul 10, 2006
- 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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | G64431 | CA | Primary |
Addresses
Primary practice location
2175 Rosaline Ave
Redding, CA 96001-2509
Mailing address
PO Box 994032
Redding, CA 96099-4032
Phone (530) 241-0473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G644310 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111028000146 | CA | Order and Referring Only - Pediatric Medicine | 2062489362 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G64431 | CA | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104850668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 994032",
"city": "REDDING",
"state": "CA",
"postal_code": "960994032",
"telephone_number": "530-241-0473",
"fax_number": "530-241-5377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2175 ROSALINE AVE",
"city": "REDDING",
"state": "CA",
"postal_code": "960012509",
"telephone_number": "530-225-7386",
"fax_number": "530-225-7266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "JULIAN",
"middle_name": "F",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "G64431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G644310",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.