NPIMap

Individual provider Active NPI

Keith V Atkinson, D.O.

  • Cardiovascular Disease Physician
  • Waterford, MI
National Provider Identifier
1164415659
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
KA012524 Issued in MI
Practice address
6889 Highland Rd
Waterford, MI 48327-1658
Phone
(248) 666-5200
Fax
(248) 666-5200
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X KA012524 MI Primary

Addresses

Primary practice location

6889 Highland Rd
Waterford, MI 48327-1658

Mailing address

6889 Highland Rd
Waterford, MI 48327-1658
Phone (248) 666-5200

Other identifiers 7

IdentifierTypeStateIssuer
5630659OtherMIBCBSM
H05020OtherMIHEALTH ALLIANCE PLAN
0F31072OtherMIBCBSM COMMON PROV ID #
4602937MedicaidMI
C8023OtherMIM-CARE
127722OtherMICARE CHOICES
4175696MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201113002521 NC Practitioner - Cardiovascular Disease (Cardiology) 3173411667 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Michigan State University College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Medical Center IncGroup PAC ID 2668377474, shared by 7 NPIs, 95 clinicians

Practice addresses (Care Compare)

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (828) 264-9664

336 Deerfield Rd
Boone, NC 28607-5008

Hospital & facility affiliations

  • Watauga Medical Center Hospital, Boone, NC, CCN 340051
  • Charles a Cannon Jr Memorial Hospital Hospital, Linville, NC, CCN 341323
  • Ashe Memorial Hospital Hospital, Jefferson, NC, CCN 341325
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • Johnson County Community Hospital Hospital, Mountain City, TN, CCN 441304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KA012524MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Medical Center Inc Cardiovascular Disease CurrentSince Feb 8, 2022 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Current Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Current Accepting new patients
Watauga Medical Center, Inc. Current Accepting new patients
Charles a Cannon Jr Memorial Hospital Inc CurrentSince Nov 1, 2020 Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Nov 1, 2020 Accepting new patients
Watauga Medical Center Inc Cardiovascular Disease CurrentSince Nov 1, 2020 Accepting new patients
Watauga Medical Center Inc CurrentSince Nov 1, 2020 Accepting new patients
Heart Care PC Cardiovascular Disease CurrentSince Aug 28, 2021 Accepting new patients
Watauga Medical Center Inc Cardiovascular Disease CurrentSince Nov 1, 2020 Accepting new patients
Watauga Medical Center, Inc. Past Accepting new patients
Charles a. Cannon, Jr. Memorial Hospital, Inc Past Accepting new patients

Locations

5100 Gateway Ctr
Flint, MI 48507
Phone (810) 733-0790

6889 Highland Rd
Waterford, MI 48327
Phone (248) 666-5200

336 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

155 Furman Rd
Ste 101
Boone, NC 28607
Phone (828) 262-4111

338 Deerfield Rd
Boone, NC 28607
Phone (828) 263-1211

200 Hospital Ave
#1
Jefferson, NC 28640
Phone (336) 246-7473

Interoperability endpoints

  • Direct secure messaging: katkinson1013737@direct.unc.nchie.net
  • FHIR API: https://api.platform.athenahealth.com/20439/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1164415659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6889 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271658",
            "telephone_number": "248-666-5200",
            "fax_number": "248-666-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6889 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271658",
            "telephone_number": "248-666-5200",
            "fax_number": "248-666-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "KEITH",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "KA012524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "5630659",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "H05020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM COMMON PROV ID #",
            "identifier": "0F31072",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4602937",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "C8023",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "127722",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4175696",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.