Individual provider Active NPI

Kristie Lynn Keeton, MD

  • Maternal & Fetal Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1295855070
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
4301074290 Issued in MI
Practice address
4918 W Clark Rd Ste 104
Ypsilanti, MI 48197-1142
Phone
(734) 528-9125
Fax
(734) 528-9263
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 4301074290 MI Primary
Obstetrics & Gynecology Physician 207V00000X 4301074290 MI

Addresses

Primary practice location

4918 W Clark Rd Ste 104
Ypsilanti, MI 48197-1142

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040726000923 MI Practitioner - Obstetrics/Gynecology 5496735771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Michigan Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 583-9125

775 S Main St
Chelsea, MI 48118-1383

Hospital & facility affiliations

  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301074290MIMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Obstetrics & Gynecology CurrentSince Jul 31, 2019 Accepting new patients
Iha Health Services Corporation Obstetrics & Gynecology Current Accepting new patients
Iha Health Service Corporation Obstetrics & Gynecology CurrentSince Jul 31, 2019 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

4350 Jackson Rd
Ste 310
Ann Arbor, MI 48103
Phone (734) 528-9125

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

4990 W Clark Rd
Ste 100
Ypsilanti, MI 48197
Phone (313) 434-4766

4918 W Clark Rd
Ste 104
Ypsilanti, MI 48197
Phone (734) 528-9125

5333 McAuley Dr
Rm 2110
Ypsilanti, MI 48197
Phone (734) 712-3967

Interoperability endpoints

  • Direct secure messaging: kkeeton37043@direct.trinity-health.org
  • Direct secure messaging: kkeeton462765@direct.hfhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1295855070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4918 W CLARK RD STE 104",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971142",
            "telephone_number": "734-528-9125",
            "fax_number": "734-528-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETON",
        "first_name": "KRISTIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MI",
            "license": "4301074290",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301074290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.