Active NPI
Jacob Bradley Keith, AGACNP
- Acute Care Nurse Practitioner
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 306974
- Practice address
- 500 W Thomas Rd Ste 500
Phoenix, AZ 85013-4220 - Phone
- (602) 406-4000
- Fax
- (602) 406-6498
- NPI assigned
- Aug 18, 2021
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 306974 | AZ | Primary |
Addresses
Primary practice location
500 W Thomas Rd Ste 500
Phoenix, AZ 85013-4220
Mailing address
500 W Thomas Rd Ste 500
Phoenix, AZ 85013-4220
Phone (602) 406-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200810 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 W Thomas Rd
680 DHMG St Joseph'S Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017
Hospital & facility affiliations
- St Josephs Hospital and Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306974 | AZ | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Queen'S Medical Center | Current | Accepting new patients | |
| The Queens Medical Center | Current | Accepting new patients | |
| Sjhmc Physician Services | Current | Accepting new patients | |
| Queens University Medical Group | Current | Accepting new patients | |
| St. Joseph'S Hospital and Medical Center | Current | Accepting new patients | |
| The Queens Medical Center | Current | Accepting new patients | |
| Kwokman Diagnostics LLC | Past | Accepting new patients |
Locations
485 S Dobson Rd
Ste 100
Chandler, AZ 85224
Phone (602) 406-4000
350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001
500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017
500 W Thomas Rd
Ste 500
Phoenix, AZ 85013
Phone (602) 406-4000
File 56765
Los Angeles, CA 90074
550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897
1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521
1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011
550 S Beretania St
Ste 702
Honolulu, HI 96813
Phone (808) 691-8808
Interoperability endpoints
- jacob.keith@620069265145860.direct.elationemr.com
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1326098005
-
- Multi-Specialty Clinic/Center
- Honolulu, HI
- NPI 1891441382
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1487693586
-
- Emergency Care Clinic/Center
- Phoenix, AZ
- NPI 1255382412
-
- General Acute Care Hospital
- Honolulu, HI
- NPI 1184612764
-
- Urgent Care Clinic/Center
- Honolulu, HI
- NPI 1235773219
-
- Clinical Medical Laboratory
- Irvine, CA
- NPI 1639764780
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1982733655
-
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772150400000",
"number": "1285300541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W THOMAS RD STE 500",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134220",
"telephone_number": "602-406-4000",
"fax_number": "602-406-6498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W THOMAS RD STE 500",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134220",
"telephone_number": "602-406-4000",
"fax_number": "602-406-6498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "JACOB",
"middle_name": "BRADLEY",
"name_prefix": "Mr.",
"credential": "AGACNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-18",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AZ",
"license": "306974",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200810",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.