NPIMap

Individual provider Active NPI

Jolie Guevara Keenan, M.D.

  • Infectious Disease Physician
  • Tacoma, WA
National Provider Identifier
1407236417
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD61018591 Issued in WA
Practice address
1624 S I St Ste 405
Tacoma, WA 98405-5094
Phone
(253) 274-4545
Fax
(253) 274-4599
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 61018591 WA
Infectious Disease Physician 207RI0200X MD61018591 WA Primary

Addresses

Primary practice location

1624 S I St Ste 405
Tacoma, WA 98405-5094

Mailing address

1624 S I St Ste 405
Tacoma, WA 98405-5094
Phone (253) 274-4545

Other identifiers 1

IdentifierTypeStateIssuer
2163044MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkeenan780603@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006001116 WA Practitioner - Infectious DiseasePractitioner - Internal Medicine 4587934161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1624 S I St
Suite 405
Tacoma, WA 98405-5094
Phone (253) 274-4545

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61018591WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Mar 6, 2023 Accepting new patients
Community Health Center of Snohomish County CurrentSince Aug 31, 2020 Accepting new patients
Community Health Center of Snohomish County CurrentSince Aug 31, 2020 Accepting new patients
Franciscan Medical Group CurrentSince Mar 6, 2023 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

1708 Yakima Ave
Ste 310
Tacoma, WA 98405
Phone (253) 207-4200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1624 S I St
Ste 405
Tacoma, WA 98405
Phone (253) 274-4545

Interoperability endpoints

  • Direct secure messaging: jkeenan780603@fhsce.catholichealth.net

Organizations & group practices 6

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 5

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1407236417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 S I ST STE 405",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055094",
            "telephone_number": "253-274-4545",
            "fax_number": "253-274-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 S I ST STE 405",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055094",
            "telephone_number": "253-274-4545",
            "fax_number": "253-274-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "JOLIE",
        "middle_name": "GUEVARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "61018591",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD61018591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2163044",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkeenan780603@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1624 S I St Ste 405",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.