Keaton Lawson Wolf

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4282 E Rockton Rd
Roscoe, IL 61073-7420

Phone

(779) 696-9000

NPI assigned

Sep 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uw Health Hospital, Rockford, IL, CCN 140228

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Swedishamerican Hospital

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1962451732
  Medicare reassignment Care Compare group
• Swedishamerican Hospital

  • Community/Retail Pharmacy
  • Rockford, IL
  • NPI 1306635982
  NPD
• Swedishamerican Hospital

  • Orthopaedic Surgery Physician
  • Belvidere, IL
  • NPI 1447480033

  Physician Assistant

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Swedishamerican Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1760542732
  Care Compare affiliation

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1497478242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 UNIVERSITY AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 E ROCKTON RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737420",
            "telephone_number": "779-696-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 University Ave",
            "address_purpose": "LOCATION",
            "city": "Dubuque",
            "state": "IA",
            "postal_code": "520015050",
            "country_code": "US",
            "telephone_number": "563-589-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWSON WOLF",
        "first_name": "KEATON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie A. Krueger, OTR, CHT
• Karen Lakis, MS, NCC, CADC, LCPC
• Jessica Lee Lane, MS-MFT, ALMFT
• Joanne M Langley, PHD
• Andrew Larson III, PT
• Lazy Dog Therapeutics P.C.
• Erin Hope Lee, RDN
• Katelyn Lewis
• Life Balance Medical Center
• Lifestyle Chiropractic Group LLC

• Physician Assistant in Roscoe, IL
• Providers in Roscoe, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.