Individual provider Active NPI

Donald T Keith, D.C.

  • Chiropractor
  • Middle Village, NY
National Provider Identifier
1114001146
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X00348-1 Issued in NY
Practice address
6660 80TH St
Suite G2
Middle Village, NY 11379-2738
Phone
(718) 894-4477
Fax
(718) 894-7177
NPI assigned
Oct 25, 2006
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X00348-1 NY Primary

Addresses

Primary practice location

6660 80TH St
Suite G2
Middle Village, NY 11379-2738

Mailing address

6660 80TH St
Suite G2
Middle Village, NY 11379-2738
Phone (718) 894-4477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000007 NY Practitioner - Chiropractic 1052587078 Practice locations: Middle Village, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 -60
Suite G2
Middle Village, NY 11379-2708

6660 80TH St
Middle Village, NY 11379-2708
Phone (718) 894-4477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003348NYMDBehavioral Analyst
X00348-1NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1114001146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6660 80TH ST",
            "address_2": "SUITE G2",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792738",
            "telephone_number": "718-894-4477",
            "fax_number": "718-894-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 80TH ST",
            "address_2": "SUITE G2",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113792738",
            "telephone_number": "718-894-4477",
            "fax_number": "718-894-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "DONALD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X00348-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.