Individual provider Active NPI

Bernard Gene Keown, MD

  • Family Medicine Physician
  • Kearney, NE
National Provider Identifier
1104866813
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14825 Issued in NE
Practice address
2810 W 35TH St
Kearney, NE 68845-2909
Phone
(308) 865-2570
Fax
(308) 865-2508
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 14825 NE
Family Medicine Physician 207Q00000X 14825 NE Primary

Addresses

Primary practice location

2810 W 35TH St
Kearney, NE 68845-2909

Mailing address

2810 W 35TH St
Kearney, NE 68845-2909
Phone (308) 865-2570

Other identifiers 3

IdentifierTypeStateIssuer
200084430BMedicaidKS
8729OtherNEMIDLANDS CHOICE
00255OtherNEBCBS OF NEBRASKA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bernardkeown@nwsmos.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20050705000343 NE Practitioner - Family PracticePractitioner - Sports Medicine 2264478965 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14825NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley County Hospital Family Medicine CurrentSince Jan 16, 2023 Accepting new patients
Valley County Hospital Current Accepting new patients
Valley County Hospital CurrentSince Jan 16, 2023 Accepting new patients
The Physician Network Family Medicine PastSince Dec 1, 2015 Accepting new patients
Good Samaritan Outreach Services Family Medicine Past Accepting new patients

Locations

207 S 26th St
Ord, NE 68862
Phone (308) 728-3606

2707 L St
Ord, NE 68862
Phone (308) 728-4200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1104866813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-865-2570",
            "fax_number": "308-865-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W 35TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452909",
            "telephone_number": "308-865-2570",
            "fax_number": "308-865-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOWN",
        "first_name": "BERNARD",
        "middle_name": "GENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NE",
            "license": "14825",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "14825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200084430B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "8729",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEBRASKA",
            "identifier": "00255",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bernardkeown@nwsmos.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2810 W 35th St",
            "city": "Kearney",
            "state": "NE",
            "country_code": "US",
            "postal_code": "688452909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.