Active NPI
Evelyn N. Keddis, M.D.
- Neurology Physician
- Morris Plains, NJ
National Provider Identifier
1518025147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 25MA02775600
- Practice address
- 59 Koch Ave
Morris Plains, NJ 07950-4400 - Phone
- (973) 538-1800
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 25MA02775600 | NJ | Primary |
Addresses
Primary practice location
59 Koch Ave
Morris Plains, NJ 07950-4400
Mailing address
3614 Gates CT
Morris Plains, NJ 07950-3485
Phone (973) 267-9792
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235606400000",
"number": "1518025147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3614 GATES CT",
"city": "MORRIS PLAINS",
"state": "NJ",
"postal_code": "079503485",
"telephone_number": "973-267-9792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 KOCH AVE",
"city": "MORRIS PLAINS",
"state": "NJ",
"postal_code": "079504400",
"telephone_number": "973-538-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEDDIS",
"first_name": "EVELYN",
"middle_name": "N.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2009-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NJ",
"license": "25MA02775600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morris Plains, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.