Individual provider Active NPI

Lynn M Keefe, MD

  • Pediatrics Physician
  • Niceville, FL
National Provider Identifier
1619957503
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0056741 Issued in FL
Practice address
2600 Partin Dr N
BLDG 300 Suite 320
Niceville, FL 32578-1542
Phone
(850) 279-6260
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0056741 FL Primary

Addresses

Primary practice location

2600 Partin Dr N
BLDG 300 Suite 320
Niceville, FL 32578-1542

Mailing address

2006 N Partin Drive
BLDG 300 Ste 320
Niceville, FL 32578
Phone (850) 279-6260

Other identifiers 2

IdentifierTypeStateIssuer
12637OtherBLUE SHIELD
054405100MedicaidFL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0056741FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Keefe, MD Pediatrics, LLC Pediatrics CurrentSince Mar 7, 2021 Accepting new patients

Locations

2600 Partin Dr N
Ste 320
Niceville, FL 32578
Phone (850) 279-6260

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1619957503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 N PARTIN DRIVE",
            "address_2": "BLDG 300 STE 320",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "32578",
            "telephone_number": "850-279-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 PARTIN DR N",
            "address_2": "BLDG 300 SUITE 320",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781542",
            "telephone_number": "850-279-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "0056741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "12637",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054405100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.