Keith W Brantley, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35063514B Issued in OH

Practice address

751 Forest Ave
Ste 301
Zanesville, OH 43701-2868

Phone

(740) 454-0804

Fax

(740) 450-3447

NPI assigned

Dec 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Genesis Medical Group LLC

  • General Practice Physician
  • Zanesville, OH
  • NPI 1063663433

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1609852672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE",
            "address_2": "STE 300",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012868",
            "telephone_number": "740-454-0804",
            "fax_number": "740-450-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE",
            "address_2": "STE 301",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012868",
            "telephone_number": "740-454-0804",
            "fax_number": "740-450-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "KEITH",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35063514B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0883101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Bragg, RN
• Cynthia Brandfass, NP
• Tracy Lynn Brandfass, PTA
• Fred K Branditz, MD
• Tiffany Branson, NP
• Sarah Elizabeth Brauning, MS,RD,LD,CDE
• Brad E Brautigan, M.D.
• Shyla M Bray, LPN
• Tamela Elaine Breidigan, LISW
• Jessica N Brenneman, MA, LPC

• Cardiovascular Disease Physician in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.