Jack K Keene, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01027792A Issued in IN

Practice address

11700 N Meridian St
Carmel, IN 46032-4656

Phone

(317) 688-3140

Fax

(317) 688-2664

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1073570529
  NPD (past)
• Emergency Medicine Specialists, P.C.

  • Emergency Medicine Physician
  • Danville, IN
  • NPI 1447365796
  NPD (past)
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1184667644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324656",
            "telephone_number": "317-688-3140",
            "fax_number": "317-688-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENE",
        "first_name": "JACK",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01027792A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100378870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa M Keathley, PT
• Kathryn Keefer, MD
• Sarah Anne Keehn, NP-C
• Douglas Edward Keen, LAT,ATC,RTR
• Matthew Keenan, MD
• Sarah Keene
• Lindsey Michelle Keesling, PHARMD
• Keith a. Alvarez, DDS, PC
• Jeffrey Glenn Kelich, MSED
• Lucinda Ruth Keller

• Emergency Medicine Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.