Individual provider Active NPI

Connie Keys, PA-C

  • Medical Physician Assistant
  • Battle Creek, MI
National Provider Identifier
1376547869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601003564 Issued in MI
Practice address
265 Fremont St
Battle Creek, MI 49017-3354
Phone
(269) 969-6159
Fax
(269) 969-6159
NPI assigned
Jun 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601003564 MI Primary

Addresses

Primary practice location

265 Fremont St
Battle Creek, MI 49017-3354

Mailing address

265 Fremont St
Battle Creek, MI 49017-3354
Phone (269) 969-6159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003564MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376547869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 FREMONT ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173354",
            "telephone_number": "269-969-6159",
            "fax_number": "269-969-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 FREMONT ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173354",
            "telephone_number": "269-969-6159",
            "fax_number": "269-969-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYS",
        "first_name": "CONNIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.