Individual provider Active NPI

Jennifer Keith, PA

  • Physician Assistant
  • Bloomington, IN
National Provider Identifier
1275015901
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002549A Issued in IN
Practice address
2907 S McIntire Dr
Bloomington, IN 47403-4225
Phone
(317) 890-2000
Fax
(317) 859-7220
NPI assigned
Aug 29, 2018
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002549A IN Primary

Addresses

Primary practice location

2907 S McIntire Dr
Bloomington, IN 47403-4225

Mailing address

679 E County Line Rd
Greenwood, IN 46143-1049
Phone (317) 890-2000

Other identifiers 1

IdentifierTypeStateIssuer
10002549AOtherINSTATE LICENSE NUMBER

Other names 1

  • Jennifer Kempfer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20181016003529 IN Practitioner - Physician Assistant 8820340086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology of Indiana LLCGroup PAC ID 7517870009, 79 clinicians

Practice addresses (Care Compare)

1270 N Post Rd
A
Indianapolis, IN 46219-4209
Phone (317) 895-6095

679 E County Line Rd
Greenwood, IN 46143-1049
Phone (317) 859-7222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.69 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
75.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of Indiana, L.L.C. CurrentSince Jul 1, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

2907 S McIntire Dr
Ste A
Bloomington, IN 47403
Phone (812) 332-8765

679 E County Line Rd
Greenwood, IN 46143
Phone (317) 807-1262

1270 N Post Rd
Ste A
Indianapolis, IN 46219
Phone (317) 895-6095

Organizations & group practices 4

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1275015901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-890-2000",
            "fax_number": "317-859-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 S MCINTIRE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034225",
            "telephone_number": "317-890-2000",
            "fax_number": "317-859-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002549A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "10002549A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KEMPFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.