NPIMap

Organization Active NPI

Keith F. Korver, M.D., Inc.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fort Bragg, CA
National Provider Identifier
1376598573
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
KEITH F. KORVER, M.D., INC.
Practice address
721 River Dr
Ste a
Fort Bragg, CA 95437-5402
Phone
(707) 573-6166
Fax
(707) 573-6165
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Keith Forrest Korver, M.D.NPI 1316946130
Title
President
Phone
(707) 569-7860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

721 River Dr
Ste a
Fort Bragg, CA 95437-5402

Mailing address

3510 Unocal PL Ste 207
Santa Rosa, CA 95403-0918
Phone (707) 569-7860

Other identifiers 1

IdentifierTypeStateIssuer
GR0090981MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Keith F Korver MD Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1376598573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 UNOCAL PL STE 207",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030918",
            "telephone_number": "707-569-7860",
            "fax_number": "707-545-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RIVER DR",
            "address_2": "STE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375402",
            "telephone_number": "707-573-6166",
            "fax_number": "707-573-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH F. KORVER, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "KORVER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "FORREST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-569-7860",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090981",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.