Active NPI
John S O'Keeffe, M.D.
- Family Medicine Physician
- Colorado Springs, CO
National Provider Identifier
1205855004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30329
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01303296 | Medicaid | CO |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120515000487 | CO | Practitioner - Family Practice | 6901795400 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30329 | CO | MD | Family 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.