Individual provider Active NPI

Christopher Julian Keating, M.D.

  • Surgery Physician
  • Lawrenceville, GA
National Provider Identifier
1407296759
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
91052 Issued in GA
Practice address
631 Professional Dr Ste 470
Lawrenceville, GA 30046-3370
Phone
(770) 513-2155
Fax
(770) 513-7833
NPI assigned
Jul 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 36085 SC
Student in an Organized Health Care Education/Training Program 390200000X 36085 SC
Surgery Physician 208600000X 91052 GA Primary

Addresses

Primary practice location

631 Professional Dr Ste 470
Lawrenceville, GA 30046-3370

Mailing address

631 Professional Dr Ste 470
Lawrenceville, GA 30046-3370
Phone (770) 513-2155

Other identifiers 3

IdentifierTypeStateIssuer
360854MedicaidSC
SCD5146121OtherSCMEDICARE PIN
SCD5147628OtherSCMEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181011001732 SC Practitioner - General Surgery 4688996788 Reassigns benefits to 1 organization
I20220420002056 GA Practitioner - General Surgery 4688996788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

631 Professional Dr
Suite 470
Lawrenceville, GA 30046-3370
Phone (770) 513-2155

Hospital & facility affiliations

  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36085SCMDPharmacist
91052GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Northside Surgical Professional Services LLC Surgery CurrentSince Mar 28, 2022 Accepting new patients
Spartanburg Medical Center CurrentSince Oct 1, 2018 Accepting new patients
Advanced Neurosurgery Associates LLC Past Accepting new patients

Locations

2800 Buford Dr
Ste 120
Buford, GA 30519
Phone (770) 643-4115

3855 Pleasant Hill Rd
Ste 470
Duluth, GA 30096
Phone (678) 312-7280

631 Professional Dr
Ste 470
Lawrenceville, GA 30046
Phone (678) 312-1940

2200 Medical Center Blvd
Ste 340
Lawrenceville, GA 30046
Phone (770) 978-0561

5185 Peachtree Pkwy
Ste 240
Peachtree Corners, GA 30092
Phone (470) 242-0716

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

2306 Wisteria Dr
Ste 200
Snellville, GA 30078
Phone (770) 978-0561

840 W Floyd Baker Blvd
Gaffney, SC 29341
Phone (864) 489-3300

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

Organizations & group practices 4

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 2

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1407296759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 470",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-513-2155",
            "fax_number": "770-513-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 470",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-513-2155",
            "fax_number": "770-513-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATING",
        "first_name": "CHRISTOPHER",
        "middle_name": "JULIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2022-04-14",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "36085",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "36085",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "91052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360854",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCD5146121",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCD5147628",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.