Johnathan P Keenum, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

76392 Issued in GA

Practice address

5901-B Peachtree Dunwoody Rd
Suite B-420
Atlanta, GA 30328

Phone

(256) 627-9518

NPI assigned

Mar 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Scottish Rite Children'S Medical Center

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1184779332
  NPD (past)
• Scottish Rite Childrens Medical Ctr

  • Children's Hospital
  • Atlanta, GA
  • NPI 1922178789
  NPD (past)

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1255655734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 CANOOCHEE DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901-B PEACHTREE DUNWOODY RD",
            "address_2": "SUITE B-420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30328",
            "telephone_number": "256-627-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENUM",
        "first_name": "JOHNATHAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-26",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "76392",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Ryan Keen, D.O.
• Selena Keenam, LPN
• David L. Keenan, M.D.
• Taylor Ann Keenan, DC
• Sarah Keene, MD
• Breanna Keeter
• William F Keeton, MD
• Kristina M Kegley, PA-C
• Emily Kehnast, L.AC., MSOM
• Teresa Ann Keil, REGISTERED NURSE

• Neonatal-Perinatal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Neonatal-Perinatal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.