Elias Graham Keith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3735 Issued in WI

Practice address

815 57TH St Ste D
Kenosha, WI 53140-4062

Phone

(262) 204-7239

NPI assigned

Jun 12, 2013

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1386082394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 57TH ST STE D",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404062",
            "telephone_number": "262-204-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 57TH ST STE D",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404062",
            "telephone_number": "262-204-7239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "ELIAS",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kazas Womens Health Center
• Nicole Kazin, RN
• Omar Kazmi, D.O.
• Jennifer L Kegley, OTR
• Sarina Keim, NP
• Kari Kellar, LPC-IT
• Jami Lynn Newcomb Keller
• Madison Kempf, OTR
• Danna Kendall
• Marc V Kennedy, M.D.

• Optometrist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.