Individual provider Active NPI

Katherine A Keeley, M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Henderson, NV
National Provider Identifier
1174570816
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
152681 Issued in MA
Practice address
2649 Wigwam Pkwy
Suite 102
Henderson, NV 89074-7310
Phone
(702) 263-9339
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 152681 MA Primary

Addresses

Primary practice location

2649 Wigwam Pkwy
Suite 102
Henderson, NV 89074-7310

Mailing address

2649 Wigwam Pkwy
#102
Henderson, NV 89074-7310
Phone (702) 263-9339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152681MAMDOral & Maxillofacial Surgery (D.M.D.)
3530NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center of Southern Nevada Past Accepting new patients
Dignity Health Past 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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174570816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 WIGWAM PKWY",
            "address_2": "#102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747310",
            "telephone_number": "702-263-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 WIGWAM PKWY",
            "address_2": "SUITE 102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747310",
            "telephone_number": "702-263-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELEY",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MA",
            "license": "152681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.