Active NPI
Phillip M Keeley, MD
- Family Medicine Physician
- Bowling Green, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 46624
- Practice address
- 130 Triple Crown CT
Bowling Green, KY 42104-8567 - Phone
- (270) 495-1755
- NPI assigned
- Apr 15, 2009
- Last updated
- Feb 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 46624 | KY | |
| Family Medicine Physician | 207Q00000X | 46624 | KY | Primary |
| Internal Medicine Physician | 207R00000X | 46624 | KY | |
| Hospitalist Physician | 208M00000X | 46624 | KY |
Addresses
Primary practice location
130 Triple Crown CT
Bowling Green, KY 42104-8567
Mailing address
130 Triple Crown CT
Bowling Green, KY 42104-8567
Phone (270) 495-1755
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207P00000X | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46624 | KY | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Physician Services PC | Internal Medicine | Current | Accepting new patients |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Kentucky Post-Acute Medical Services 1 PSC | Hospitalist | Current | Accepting new patients |
| Emergency Coverage, LLC | Emergency Medicine | Past | Accepting new patients |
| Emergency Medical Care Facilities PC | Emergency Medicine | Past | Accepting new patients |
Locations
723 Burkesville Rd
Albany, KY 42602
Phone (606) 387-6421
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141
310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612
1501 S Dixie St
Park, KY 42749
Phone (270) 786-2191
360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818
Organizations & group practices 5
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.
-
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Hospitalist
-
- Emergency Medicine Physician
- Maysville, KY
- NPI 1356379382
-
- Hospitalist Physician
- Oak Ridge, TN
- NPI 1083835441
Internal Medicine, KY
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Emergency Medicine
-
- Emergency Medicine Physician
- Jackson, TN
- NPI 1538345855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613347200000",
"number": "1417190703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 TRIPLE CROWN CT",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421048567",
"telephone_number": "270-495-1755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 TRIPLE CROWN CT",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421048567",
"telephone_number": "270-495-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEELEY",
"first_name": "PHILLIP",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-15",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "46624",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "46624",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "46624",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "KY",
"license": "46624",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207P00000X",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.