Thomas R. Keucher, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

01024403A Issued in IN

Practice address

100 Navarre PL
Suite 6600
South Bend, IN 46601-1156

Phone

(574) 232-7227

Fax

(574) 232-2064

NPI assigned

Jun 30, 2006

Last updated

Oct 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1114956497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL",
            "address_2": "SUITE 6600",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011156",
            "telephone_number": "574-232-7227",
            "fax_number": "574-232-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL",
            "address_2": "SUITE 6600",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011156",
            "telephone_number": "574-232-7227",
            "fax_number": "574-232-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEUCHER",
        "first_name": "THOMAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01024403A",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IN",
            "license": "01024403A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100346270A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in South Bend, IN
• Providers in South Bend, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.