Keith R Felder Sr.

Primary specialty

Transportation BrokerTaxonomy code 347E00000X

Practice address

24658 Constellation Way
Moreno Valley, CA 92551-7296

Phone

(951) 340-7072

NPI assigned

Dec 18, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1508634700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24658 CONSTELLATION WAY",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925517296",
            "telephone_number": "951-340-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24658 CONSTELLATION WAY",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925517296",
            "telephone_number": "951-340-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDER",
        "first_name": "KEITH",
        "middle_name": "R",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawavian A Farmer
• Elias Farr
• Nasim Faryabi, DO
• Frederica Fayad, M.D
• Reggie Federico
• Peter Paul Feliciano, D.M.D.
• Jennesy E Felix
• Dow Hsueh Feng, PHARMD
• Anthony Tyron Fenison, M.D.
• Natalie Suzanne Fenske, DO

• Transportation Broker in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Transportation Broker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.