Individual provider Active NPI

John S O'Keeffe, M.D.

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1205855004
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30329 Issued in CO
Practice address
8890 North Union Blvd
Suite 170
Colorado Springs, CO 80920-2701
Phone
(719) 364-5005
Fax
(719) 365-9911
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 30329 CO Primary

Addresses

Primary practice location

8890 North Union Blvd
Suite 170
Colorado Springs, CO 80920-2701

Mailing address

8890 N Union Blvd Ste 170
Colorado Springs, CO 80920-2701
Phone (719) 364-5005

Other identifiers 1

IdentifierTypeStateIssuer
01303296MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000487 CO Practitioner - Family Practice 6901795400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30329COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1205855004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 N UNION BLVD STE 170",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202701",
            "telephone_number": "719-364-5005",
            "fax_number": "719-365-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 NORTH UNION BLVD",
            "address_2": "SUITE 170",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202701",
            "telephone_number": "719-364-5005",
            "fax_number": "719-365-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFFE",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01303296",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.