Individual provider Active NPI

Chris McKeown, FNP-C

  • Family Nurse Practitioner
  • Salem, OR
National Provider Identifier
1154916773
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202107301NP-PP Issued in OR
Practice address
675 Orchard Heights Rd NW Ste 120
Salem, OR 97304-3042
Phone
(815) 499-4742
NPI assigned
Mar 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022602 IL
Family Nurse Practitioner 363LF0000X 202107301NP-PP OR Primary

Addresses

Primary practice location

675 Orchard Heights Rd NW Ste 120
Salem, OR 97304-3042

Mailing address

675 Orchard Heights Rd NW Ste 120
Salem, OR 97304-3042
Phone (815) 499-4742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20210311001351 IL Practitioner - Nurse Practitioner 7012323314 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209022602ILMDNurse Practitioner
202107301NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Vision LLC CurrentSince Mar 24, 2021 Accepting new patients
Cardiorenal Therapeutics of Illinois PLLC CurrentSince Feb 1, 2021 Accepting new patients

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": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1154916773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 ORCHARD HEIGHTS RD NW STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043042",
            "telephone_number": "815-499-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 ORCHARD HEIGHTS RD NW STE 120",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043042",
            "telephone_number": "815-499-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEOWN",
        "first_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-05",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022602",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202107301NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.