Active NPI
Gerald Keener Jr., MD
- Ophthalmology Physician
- Indianapolis, IN
National Provider Identifier
1386636413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 010-22214
- Practice address
- 1400 N Ritter Ave
Ste 276
Indianapolis, IN 46219-3052 - Phone
- (317) 352-1841
- Fax
- (317) 352-0097
- NPI assigned
- Aug 16, 2005
- Last updated
- Aug 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 010-22214 | IN | Primary |
Addresses
Primary practice location
1400 N Ritter Ave
Ste 276
Indianapolis, IN 46219-3052
Mailing address
1400 N Ritter Ave
Ste 276
Indianapolis, IN 46219-3052
Phone (317) 352-1841
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100055680 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 010-22214 | IN | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Ophthalmology | Past | Accepting new patients |
| Indiana University Eye Care Inc. | Ophthalmology | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Indianapolis, IN
- NPI 1548261894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219017600000",
"number": "1386636413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N RITTER AVE",
"address_2": "STE 276",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462193052",
"telephone_number": "317-352-1841",
"fax_number": "317-352-0097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N RITTER AVE",
"address_2": "STE 276",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462193052",
"telephone_number": "317-352-1841",
"fax_number": "317-352-0097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENER",
"first_name": "GERALD",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2008-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "010-22214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100055680",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.