Organization Active NPI

Keith F. Korver, M.D., Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lakeport, CA
National Provider Identifier
1164469284
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
KEITH F. KORVER, M.D., INC.
Practice address
5196 Hill Rd E
Ste 202
Lakeport, CA 95453-6360
Phone
(707) 263-1777
Fax
(707) 263-8137
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Keith Forrest Korver, M.D.NPI 1316946130
Title
President
Phone
(707) 569-7860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

5196 Hill Rd E
Ste 202
Lakeport, CA 95453-6360

Mailing address

3510 Unocal PL Ste 207
Santa Rosa, CA 95403-0918
Phone (707) 569-7860

Other identifiers 1

IdentifierTypeStateIssuer
GR0090986MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Keith F Korver MD Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1164469284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 UNOCAL PL STE 207",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030918",
            "telephone_number": "707-569-7860",
            "fax_number": "707-545-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5196 HILL RD E",
            "address_2": "STE 202",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536360",
            "telephone_number": "707-263-1777",
            "fax_number": "707-263-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH F. KORVER, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "KORVER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "FORREST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-569-7860",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.