Individual provider Active NPI

Jeffrey Keating, FNP-C

  • Family Nurse Practitioner
  • Wilmington, MA
National Provider Identifier
1114531258
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2306558 Issued in MA
Practice address
222 Main St
Wilmington, MA 01887-2341
Phone
(855) 389-2727
NPI assigned
Sep 5, 2020
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2306558 MA Primary

Addresses

Primary practice location

222 Main St
Wilmington, MA 01887-2341

Mailing address

222 Main St
Wilmington, MA 01887-2341
Phone (203) 241-1708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217001579 MA Practitioner - Nurse Practitioner 5294147179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Massachusetts, LLCGroup PAC ID 2264594944, 106 clinicians

Practice addresses (Care Compare)

68 Main St
Andover, MA 01810-3846
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Massachusetts LLC Family CurrentSince Oct 13, 2020 Accepting new patients

Locations

68 Main St
Andover, MA 01810
Phone (978) 470-0542

270 Grove St
Braintree, MA 02184
Phone (781) 356-0714

311 Newbury St
Danvers, MA 01923
Phone (978) 605-0100

1025 Central St
Stoughton, MA 02072
Phone 7813416114 ext. 8221

222 Main St
Wilmington, MA 01887
Phone (855) 389-2727

1 Cvs Dr
#2295
Woonsocket, RI 02895
Phone (401) 770-8043

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1114531258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872341",
            "telephone_number": "203-241-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MAIN ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872341",
            "telephone_number": "855-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATING",
        "first_name": "JEFFREY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-05",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2306558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.