Active NPI
Kruan Christie Keolamphu, MD
- Internal Medicine Physician
- Scarsdale, NY
National Provider Identifier
1417175357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 243649-1
- Practice address
- 259 Heathcote Rd
Scarsdale, NY 10583-4523 - Phone
- (914) 723-8100
- Fax
- (914) 219-1928
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 243649-1 | NY | Primary |
Addresses
Primary practice location
259 Heathcote Rd
Scarsdale, NY 10583-4523
Mailing address
259 Heathcote Rd
Scarsdale, NY 10583-4523
Phone (914) 723-8100
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 243649-1 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283385600000",
"number": "1417175357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 HEATHCOTE RD",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "105834523",
"telephone_number": "914-723-8100",
"fax_number": "914-219-1928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 HEATHCOTE RD",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "105834523",
"telephone_number": "914-723-8100",
"fax_number": "914-219-1928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOLAMPHU",
"first_name": "KRUAN",
"middle_name": "CHRISTIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2010-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "243649-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scarsdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.