Individual provider Active NPI

Kevin Newell Keenan, MD

  • Occupational Medicine Physician
  • Portsmouth, NH
National Provider Identifier
1396706677
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
9656 Issued in NH
Practice address
1 Ayres Circle
Naval Branch Health Clinic Building H-1
Portsmouth, NH 03804
Phone
(207) 438-5981
Fax
(207) 438-1527
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 29931 NC
Public Health & General Preventive Medicine Physician 2083P0901X 150196 MA
Occupational Medicine Physician 2083X0100X 9656 NH Primary

Addresses

Primary practice location

1 Ayres Circle
Naval Branch Health Clinic Building H-1
Portsmouth, NH 03804

Mailing address

1 Ayres Circle
Naval Branch Health Clinic Building H-1
Portsmouth, NH 03804
Phone (207) 438-5981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120216000010 NH Order and Referring Only - Preventive MedicinePractitioner - Preventive Medicine 1254599574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29931NCMDPharmacist
150196MAMDPublic Health & General Preventive Medicine Physician
9656NHMDOccupational Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1396706677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AYRES CIRCLE",
            "address_2": "NAVAL BRANCH HEALTH CLINIC BUILDING H-1",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03804",
            "telephone_number": "207-438-5981",
            "fax_number": "207-438-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AYRES CIRCLE",
            "address_2": "NAVAL BRANCH HEALTH CLINIC BUILDING H-1",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03804",
            "telephone_number": "207-438-5981",
            "fax_number": "207-438-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "KEVIN",
        "middle_name": "NEWELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "NC",
            "license": "29931",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MA",
            "license": "150196",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NH",
            "license": "9656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.