Kelly Shannon Keefe, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A48069 Issued in CA

Practice address

3969 4TH Ave
Suite 301
San Diego, CA 92103

Phone

(619) 532-6702

Fax

(619) 532-7272

NPI assigned

Mar 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkeefe8216@direct.llu.edu
• Direct secure messaging: kkeefe81182@scrippshlth.medalliesdirect.net

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.

• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Loma Linda University Pathology Medical Group, Inc.

  • Anatomic Pathology Physician
  • Loma Linda, CA
  • NPI 1457398505
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Ophthalmology Physician
  • Loma Linda, CA
  • NPI 1437109469
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Neurological Surgery Physician
  • Murrieta, CA
  • NPI 1912004920
  NPD
• Loma Linda University Pathology Medical Group, Inc.

  • Anatomic Pathology Physician
  • Loma Linda, CA
  • NPI 1205881026
  NPD
• Loma Linda University Pathology Medical Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Murrieta, CA
  • NPI 1659664654
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Loma Linda University Children'S Hospital

  • Children's Hospital
  • Loma Linda, CA
  • NPI 1366866345
  NPD (past)
• Loma Linda University Medical Center

  • General Acute Care Hospital
  • Loma Linda, CA
  • NPI 1194731935
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1114987658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "SUITE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-291-6191",
            "fax_number": "619-291-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 4TH AVE",
            "address_2": "SUITE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-532-6702",
            "fax_number": "619-532-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "KELLY",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A48069",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A48069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nawal Keddo
• Jonathan Kee, MSN, APRN, FNP-BC
• Derik W Keeble
• Richard Mark Keedy, F.N.P.
• Julia Keefe
• Magdalena Keefe
• Michael Arthur Keefe, M.D.
• Morgan Shannon Keefe, DO, MPH
• Patricia Mero Keefe
• Sarah Keefe, OT

• Ophthalmology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.

Verify at the official NPI Registry.