Individual provider Active NPI

Jennifer Keer, PA-C

  • Medical Physician Assistant
  • Shamokin, PA
National Provider Identifier
1205869997
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA002420L Issued in PA
Practice address
255 W Spruce St
Shamokin, PA 17872-5811
Phone
(570) 644-5050
NPI assigned
Jul 8, 2006
Last updated
Jan 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA002420L PA Primary

Addresses

Primary practice location

255 W Spruce St
Shamokin, PA 17872-5811

Mailing address

255 W Spruce St
Shamokin, PA 17872-5811
Phone (570) 644-5050

Other identifiers 4

IdentifierTypeStateIssuer
044893OtherPASR/BL
0015644200005MedicaidPA
104839OtherPAB/LUN
01025201OtherPAKHP/B

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160104000907 PA Order and Referring Only - Physician Assistant 4981634102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1205869997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W SPRUCE ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178725811",
            "telephone_number": "570-644-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W SPRUCE ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178725811",
            "telephone_number": "570-644-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEER",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA002420L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SR/BL",
            "identifier": "044893",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015644200005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/LUN",
            "identifier": "104839",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KHP/B",
            "identifier": "01025201",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shamokin, PA

Sources for this page

Verify at the official NPI Registry.