Individual provider Active NPI

Thomas A Keith, M.D.

  • Family Medicine Physician
  • Palmetto, FL
National Provider Identifier
1154421717
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME111881 Issued in FL
Practice address
606 4TH Ave W
Palmetto, FL 34221-5226
Phone
(941) 722-7785
Fax
(941) 729-5267
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M2363 TX
Family Medicine Physician 207Q00000X ME111881 FL Primary

Addresses

Primary practice location

606 4TH Ave W
Palmetto, FL 34221-5226

Mailing address

404 Barcelona Ave
Venice, FL 34285-1754
Phone (941) 483-4705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120816000612 FL Practitioner - Family Practice 2860648367 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME111881FLMDFamily Medicine Physician
M2363TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Global Physician Network LLC Series II CurrentSince Sep 1, 2017 Accepting new patients
Ambulatory Care Physicians of Sarasota LLC Past Accepting new patients

Locations

1040 River Heritage Blvd
Bradenton, FL 34212
Phone (941) 917-6440

6331 S Tamiami Trl
#1
Sarasota, FL 34231
Phone (941) 917-5678

6331 S Tamiami Trl
Sarasota, FL 34231
Phone (941) 917-5678

Organizations & group practices 2

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1154421717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 BARCELONA AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342851754",
            "telephone_number": "941-483-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 4TH AVE W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215226",
            "telephone_number": "941-722-7785",
            "fax_number": "941-729-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M2363",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, FL

Sources for this page

Verify at the official NPI Registry.