Individual provider Active NPI

John Thomas Keil, R.PH

  • Pharmacist
  • Racine, WI
National Provider Identifier
1407132194
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8240 Issued in WI
Practice address
116 Northwood Dr
Racine, WI 53402-1938
Phone
(262) 639-3423
NPI assigned
Oct 26, 2011
Last updated
Oct 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8240 WI Primary
Pharmacist 183500000X 10923 CO

Addresses

Primary practice location

116 Northwood Dr
Racine, WI 53402-1938

Mailing address

116 Northwood Dr
Racine, WI 53402-1938
Phone (262) 639-3423

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
10923COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1407132194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 NORTHWOOD DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534021938",
            "telephone_number": "262-639-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 NORTHWOOD DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534021938",
            "telephone_number": "262-639-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIL",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "8240",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "10923",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.