Active NPI
Keaton William Cooley-Rieders
- Student in an Organized Health Care Education/Training Program
- Cincinnati, OH
National Provider Identifier
1508491630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 234 Goodman Street
Division of Thoracic Surgery
Cincinnati, OH 45219 - Phone
- (513) 584-1387
- NPI assigned
- Mar 9, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Critical Care Medicine Registered Nurse | 163WC0200X | 95049043 | CA |
Addresses
Primary practice location
234 Goodman Street
Division of Thoracic Surgery
Cincinnati, OH 45219
Mailing address
231 Albert Sabin Way # 0558
Cincinnati, OH 45267-2827
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95049043 | CA | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1508491630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 ALBERT SABIN WAY # 0558",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452672827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 GOODMAN STREET",
"address_2": "DIVISION OF THORACIC SURGERY",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45219",
"telephone_number": "513-584-1387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOLEY-RIEDERS",
"first_name": "KEATON",
"middle_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-09",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "CA",
"license": "95049043",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.