Individual provider Active NPI

David W Keckich, M.D.

  • Infectious Disease Physician
  • Flagstaff, AZ
National Provider Identifier
1356370571
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
37780 Issued in AZ
Practice address
1215 N Beaver St
Flagstaff, AZ 86001-3126
Phone
(928) 773-2200
Fax
(928) 773-2300
NPI assigned
Jul 1, 2006
Last updated
May 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 37780 AZ Primary

Addresses

Primary practice location

1215 N Beaver St
Flagstaff, AZ 86001-3126

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
437073MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090721000168 AZ Practitioner - Infectious Disease 6901958057 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of Maryland School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northland CaresGroup PAC ID 3577627322, 3 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

3188 N Windsong Dr
Suite a
Prescott Valley, AZ 86314-1220
Phone (928) 776-4612

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37780AZMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Cares CurrentSince Jul 23, 2014 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Oct 16, 2018 Accepting new patients
Flagstaff Pathology Associates Current Accepting new patients
Verde Valley Medical Center CurrentSince Jul 7, 2018 Accepting new patients
Verde Valley Medical Center CurrentSince Jul 7, 2018 Accepting new patients
Northern Arizona Healthcare Corporation Internal Medicine CurrentSince Oct 16, 2018 Accepting new patients
County of Yavapai Current Accepting new patients
County of Yavapai Past Accepting new patients

Locations

1298 W Finnie Flat Rd
Ste 101
Camp Verde, AZ 86322
Phone (928) 639-5555

203 S Candy Ln
Ste 4A
Cottonwood, AZ 86326
Phone (928) 649-1389

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

450 S Willard St
Ste 107
Cottonwood, AZ 86326
Phone (928) 639-0909

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1485 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 774-6626

1090 Commerce Dr
Prescott, AZ 86305
Phone (928) 583-1000

3112 Clearwater Dr
Ste A
Prescott, AZ 86305
Phone (928) 582-2525

3188 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 775-9430

61 Bell Rock Plz
Ste A
Sedona, AZ 86351
Phone (928) 204-4999

5475 Walnut Ave
Ste C
Chino, CA 91710
Phone (909) 465-0292

Interoperability endpoints

  • Direct secure messaging: david.keckich.p1@direct.ycchs.nextgenshare.com

Organizations & group practices 9

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 7

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1356370571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013126",
            "telephone_number": "928-773-2200",
            "fax_number": "928-773-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECKICH",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "37780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "437073",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.