Individual provider Active NPI

Keim Thomas Houser, M.D.

  • Obstetrics & Gynecology Physician
  • South Bend, IN
National Provider Identifier
1376597757
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01022611A Issued in IN
Practice address
515 N Lafayette Blvd
South Bend, IN 46601-1003
Phone
(574) 232-2037
Fax
(574) 232-1420
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01022611A IN Primary

Addresses

Primary practice location

515 N Lafayette Blvd
South Bend, IN 46601-1003

Mailing address

515 N Lafayette Blvd
South Bend, IN 46601-1003
Phone (574) 232-2037

Other identifiers 1

IdentifierTypeStateIssuer
100220030AMedicaidIN

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01022611AINMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1376597757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N LAFAYETTE BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011003",
            "telephone_number": "574-232-2037",
            "fax_number": "574-232-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N LAFAYETTE BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011003",
            "telephone_number": "574-232-2037",
            "fax_number": "574-232-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSER",
        "first_name": "KEIM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01022611A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100220030A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.