Active NPI
Richard George Keightley, M.D.
- Allergy Physician
- Phoenix, AZ
National Provider Identifier
1568460616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 11856
- Practice address
- 20940 N Tatum Blvd
Ste 205
Phoenix, AZ 85050-7260 - Phone
- (480) 991-1930
- Fax
- (480) 443-8196
- NPI assigned
- Jul 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | 11856 | AZ | Primary |
| Pediatric Allergy/Immunology Physician | 2080P0201X | 11856 | AZ |
Addresses
Primary practice location
20940 N Tatum Blvd
Ste 205
Phoenix, AZ 85050-7260
Mailing address
20940 N Tatum Blvd
Ste 205
Phoenix, AZ 85050-7260
Phone (480) 991-1930
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0200027 | Other | AZ | UHC |
| 0200027 | Other | AZ | UNITED HEALTH CARE |
| 2572627 | Other | AZ | AETNA HMO |
| 4022160 | Other | AZ | AETNA PPO |
| 1Z2992 | Other | AZ | HEALTHNET |
| AZ0027920 | Other | AZ | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11856 | AZ | MD | Pediatric Allergy/Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1568460616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20940 N TATUM BLVD",
"address_2": "STE 205",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850507260",
"telephone_number": "480-991-1930",
"fax_number": "480-443-8196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20940 N TATUM BLVD",
"address_2": "STE 205",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850507260",
"telephone_number": "480-991-1930",
"fax_number": "480-443-8196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEIGHTLEY",
"first_name": "RICHARD",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "AZ",
"license": "11856",
"primary": true
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "AZ",
"license": "11856",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "0200027",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "0200027",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2572627",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4022160",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "1Z2992",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "AZ0027920",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.