NPIMap

Individual provider Active NPI

Amanda Mae McKeith, MD

  • Family Medicine Physician
  • Bisbee, AZ
National Provider Identifier
1205415163
Registry record updated Sep 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74041 Issued in AZ
Practice address
101 Cole Ave # Ae
Bisbee, AZ 85603-1327
Phone
(520) 432-5383
NPI assigned
Apr 6, 2021
Last updated
Sep 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 74041 AZ Primary

Addresses

Primary practice location

101 Cole Ave # Ae
Bisbee, AZ 85603-1327

Mailing address

101 Cole Ave # Ae
Bisbee, AZ 85603-1327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241028003776 AZ Practitioner - Family PracticePractitioner - Hospitalist 2769891035 Reassigns benefits to 2 organizations
I20241111000069 TX Practitioner - Family Practice 2769891035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bisbee Hospital AssociationGroup PAC ID 5092626168, shared by 4 NPIs, 69 clinicians

Practice addresses (Care Compare)

101 Cole Ave
Bisbee, AZ 85603-1327
Phone (520) 432-5383

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

7 Bisbee Rd
Bisbee, AZ 85603-1140
Phone (520) 432-2042

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bisbee Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 25, 2024 Accepting new patients
Southeast Alaska Regional Health Constortium CurrentSince Oct 25, 2024 Accepting new patients
Bisbee Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
Bisbee Hospital Association CurrentSince Oct 1, 2024 Accepting new patients

Locations

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383

7 Bisbee Rd
Bisbee, AZ 85603
Phone (520) 432-2042

100 E 5th St
Douglas, AZ 85607
Phone (520) 364-7659

10524 E Highway 92
Hereford, AZ 85615
Phone (520) 366-0300

4524 E Hereford Rd
Ste 1
Hereford, AZ 85615

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726963200000",
    "number": "1205415163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 COLE AVE # AE",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "856031327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COLE AVE # AE",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "856031327",
            "telephone_number": "520-432-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEITH",
        "first_name": "AMANDA",
        "middle_name": "MAE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-09-22",
        "certification_date": "2024-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "74041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bisbee, AZ

Sources for this page

Verify at the official NPI Registry.