Keetoowah Healthcare Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KEETOOWAH HEALTHCARE SERVICES, LLC

Practice address

16414 W 760 Rd
Tahlequah, OK 74464-1675

Phone

(918) 525-9595

Fax

(918) 525-9590

NPI assigned

Feb 27, 2026

Organization subpart

No

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

Authorized official

Name

Fredo Anderson

Title

Executive

Phone

(918) 395-6699

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1417802224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744651245",
            "telephone_number": "918-525-9595",
            "fax_number": "918-525-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16414 W 760 RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744641675",
            "telephone_number": "918-525-9595",
            "fax_number": "918-525-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEETOOWAH HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "FREDO",
        "authorized_official_title_or_position": "EXECUTIVE",
        "authorized_official_telephone_number": "918-395-6699"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Mae Kacirek, LPC-C, LADCMH-C
• Jeesoo Daniel Kang, DO
• Prashant Kaushik, MD
• Levi Taylor Keehler, M.S., LPC, LADC, CPS
• Chase Anthony Keene
• Patricia Kehoe
• Kevin D Kelly
• Louissa Dawn Kelly
• Billie D Kennedy
• Elaine Kennedy, M.D.

• Family Medicine Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.