Individual provider Active NPI

James W Keith, DO

  • Family Medicine Physician
  • Owensville, MO
National Provider Identifier
1417022815
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO33557 Issued in MO
Practice address
708 E Highway 28
Owensville, MO 65066-1588
Phone
(573) 437-4481
Fax
(573) 437-3232
NPI assigned
Nov 21, 2006
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO33557 MO Primary

Addresses

Primary practice location

708 E Highway 28
Owensville, MO 65066-1588

Mailing address

PO Box 19
Hermann, MO 65041-0019
Phone (573) 486-1193

Other identifiers 1

IdentifierTypeStateIssuer
240697748MedicaidMO

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
DO33557MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hermann Area Hospital District Past Accepting new patients
Hermann Area Hospital District 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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1417022815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19",
            "city": "HERMANN",
            "state": "MO",
            "postal_code": "650410019",
            "telephone_number": "573-486-1193",
            "fax_number": "573-486-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 E HIGHWAY 28",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650661588",
            "telephone_number": "573-437-4481",
            "fax_number": "573-437-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "DO33557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240697748",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.