Individual provider Active NPI

Deangelia Renae Keiffer, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1376883710
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1947 Issued in KY
Practice address
1401 Harrodsburg Rd
Suite B-275
Lexington, KY 40504-3751
Phone
(859) 278-2334
Fax
(859) 278-0159
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA1947 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd
Suite B-275
Lexington, KY 40504-3751

Mailing address

PO Box 936
London, KY 40743-0936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150311002272 KY Practitioner - Physician Assistant 1759527328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentuckyone Health Medical Group IncGroup PAC ID 8820993702, 260 clinicians

Practice addresses (Care Compare)

1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone (859) 313-1000

1401 Harrodsburg Rd
Suite A300
Lexington, KY 40504-3787
Phone (859) 276-4429

2750 Battlefield Memorial Hwy
Berea, KY 40403-8332
Phone (859) 968-0302

305 Estill St
Berea, KY 40403-1742
Phone (859) 986-8418

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Lexington, KY, CCN 180010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2322TNMDAnatomic Pathology & Clinical Pathology Physician
PA1947KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurgical Associates PSC Current Accepting new patients
Kentuckyone Health Medical Group, Inc. Physician Assistant CurrentSince Jan 31, 2015 Accepting new patients

Locations

305 Estill St
Berea, KY 40403
Phone (859) 986-1415

1401 Harrodsburg Rd
Ste A300
Lexington, KY 40504
Phone (859) 313-4744

1401 Harrodsburg Rd
Ste B275
Lexington, KY 40504
Phone (859) 277-9436

100 E Liberty St
Ste 800
Louisville, KY 40202
Phone (502) 540-3339

Interoperability endpoints

  • Direct secure messaging: dscott275278@direct.stlukeshealth.org
  • Direct secure messaging: deangeliascott@kysjhspe.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1376883710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "fax_number": "606-330-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD",
            "address_2": "SUITE B-275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043751",
            "telephone_number": "859-278-2334",
            "fax_number": "859-278-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIFFER",
        "first_name": "DEANGELIA",
        "middle_name": "RENAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.