Individual provider Active NPI

Michelle Marie Keeter, MD

  • Family Medicine Physician
  • Crescent City, CA
National Provider Identifier
1487919544
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A130812 Issued in CA
Practice address
5905 Lake Earl Dr
Crescent City, CA 95532-0002
Phone
(707) 465-1000
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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 A130812 CA Primary

Addresses

Primary practice location

5905 Lake Earl Dr
Crescent City, CA 95532-0002

Mailing address

5905 Lake Earl Dr
Crescent City, CA 95532-0002
Phone (707) 465-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180328001581 CA Practitioner - Family Practice 6901109800 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130812CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers CurrentSince Feb 26, 2018 Accepting new patients
Open Door Community Health Centers CurrentSince Feb 26, 2018 Accepting new patients

Locations

1275 8th St
Arcata, CA 95521

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636

670 9th St
Ste 203
McKinleyville, CA 95521

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1487919544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 LAKE EARL DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955320002",
            "telephone_number": "707-465-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 LAKE EARL DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955320002",
            "telephone_number": "707-465-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETER",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A130812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.