Individual provider Active NPI

Keith Edward Wright, DO

  • Family Medicine Physician
  • Hancock, MI
National Provider Identifier
1508836719
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5010103509 Issued in MI
Practice address
500 Campus Dr
Hancock, MI 49930-1452
Phone
(906) 483-1730
Fax
(906) 483-1380
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 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 5010103509 MI Primary

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1452

Mailing address

500 Campus Dr
Hancock, MI 49930-1452
Phone (906) 483-1730

Other identifiers 1

IdentifierTypeStateIssuer
418159511MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090414000364 MI Practitioner - Family Practice 3779630561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians
Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

500 Campus Dr
Hancock, MI 49930-1452
Phone (906) 483-1060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5010103509MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portage Physician Practices Inc Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Portage Physician Practices Inc CurrentSince Mar 1, 2020 Accepting new patients

Locations

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

500 Campus Dr
Ste 4
Hancock, MI 49930
Phone (906) 483-1730

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

Interoperability endpoints

  • Direct secure messaging: keith.wright.1@8233.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1508836719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452",
            "telephone_number": "906-483-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452",
            "telephone_number": "906-483-1730",
            "fax_number": "906-483-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KEITH",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5010103509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418159511",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.