Matthew Thomas Keely, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704328616 Issued in MI

Practice address

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Phone

(810) 606-5000

NPI assigned

Aug 9, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1596931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596931200000",
    "number": "1306456801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 WINTERS EAVE",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "484331947",
            "telephone_number": "810-610-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELY",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-09",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704328616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "4704328616",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ali Ahmed Karrar, M.D.
• Kristine Kase
• Selena Rod Kassab, DO
• Mohammed Shozab Kazim, DO
• Allison Sokol Keel, D.O.
• Elissa Keller
• Teresa Lynn Keller, PTA
• Kellogg Speech Language Learning Services
• Kathryn Kellogg
• Kristin Marie Kelly, PT

• Registered Nurse in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2020; 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.