Individual provider Active NPI

Shannon Kathleen Keel, M.D.

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1558351940
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40426 Issued in CO
Practice address
1160 Patterson Rd
Grand Junction, CO 81506-8275
Phone
(970) 298-2800
Fax
(970) 298-7522
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD428949 PA
Family Medicine Physician 207Q00000X 40426 CO Primary

Addresses

Primary practice location

1160 Patterson Rd
Grand Junction, CO 81506-8275

Mailing address

2040 J 1/2 Rd
Fruita, CO 81521-9346

Other identifiers 3

IdentifierTypeStateIssuer
10883061MedicaidNM
64502872MedicaidCO
810516MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20251010000646 CO Order and Referring Only - Family PracticePractitioner - Family Practice 2264345461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40426COMDFamily Medicine Physician
MD428949PAMDFamily Medicine Physician
MD428948PAMDPediatric Cardiology Physician

Interoperability endpoints

  • Direct secure messaging: shannon.keel.1@16660.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1558351940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 J 1/2 RD",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815219346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 PATTERSON RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068275",
            "telephone_number": "970-298-2800",
            "fax_number": "970-298-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEL",
        "first_name": "SHANNON",
        "middle_name": "KATHLEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD428949",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "40426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10883061",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64502872",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810516",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.