Organization Active NPI

Nabil Keith MD LLC

  • Family Medicine Physician
  • Dawsonville, GA
National Provider Identifier
1215579321
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NABIL KEITH MD LLC
Practice address
150 Northside Dawson Dr
Dawsonville, GA 30534-7696
Phone
(706) 216-4444
Fax
(706) 429-1140
NPI assigned
Oct 9, 2019
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Nabil Keith, MDNPI 1306032198
Title
Owner
Phone
(706) 216-4444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

150 Northside Dawson Dr
Dawsonville, GA 30534-7696

Mailing address

150 Northside Dawson Dr
Dawsonville, GA 30534-7696
Phone (706) 216-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200722003053 GA Part B Supplier - Clinic/Group Practice 6507280633 Receives reassigned benefits from 1 practitioner
Practice locations: Dawsonville, GA

National Provider Directory

National Provider Directory

Locations

150 Northside Dawson Dr
Dawsonville, GA 30534
Phone (706) 216-4444

150 Northside Dawson Dr
#100
Dawsonville, GA 30534

6002 Highway 53 E
Ste 130
Dawsonville, GA 30534
Phone (706) 265-8002

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1215579321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NORTHSIDE DAWSON DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305347696",
            "telephone_number": "706-216-4444",
            "fax_number": "706-429-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NORTHSIDE DAWSON DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305347696",
            "telephone_number": "706-216-4444",
            "fax_number": "706-429-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NABIL KEITH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-216-4444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.