Individual provider Active NPI

Anthony J Keele, MD

  • Family Medicine Physician
  • Cape Girardeau, MO
National Provider Identifier
1467589663
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2002008827 Issued in MO
Practice address
1417 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171
Phone
(573) 334-6053
Fax
(573) 334-7855
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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 2002008827 MO Primary

Addresses

Primary practice location

1417 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171

Mailing address

1417 N Mount Auburn Rd
Cape Girardeau, MO 63701-2171
Phone (573) 803-2941

Other identifiers 2

IdentifierTypeStateIssuer
205849003MedicaidMO
DA4814OtherMORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250419000108 MO Order and Referring Only - Family PracticePractitioner - Family Practice 3476625120

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1467589663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-803-2941",
            "fax_number": "573-803-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-334-6053",
            "fax_number": "573-334-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELE",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2002008827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205849003",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA4814",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.