Individual provider Active NPI

Thomas W Keaveney, M.D.

  • General Practice Physician
  • Lansing, MI
National Provider Identifier
1629410725
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301060467 Issued in MI
Practice address
1322 E Michigan Ave
Suite 101
Lansing, MI 48912-2199
Phone
(517) 364-3900
Fax
(517) 364-3514
NPI assigned
Jul 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301060467 MI Primary

Addresses

Primary practice location

1322 E Michigan Ave
Suite 101
Lansing, MI 48912-2199

Mailing address

1322 E Michigan Ave
Suite 101
Lansing, MI 48912-2199
Phone (517) 364-3900

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
4301060467MIMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1629410725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 E MICHIGAN AVE",
            "address_2": "SUITE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122199",
            "telephone_number": "517-364-3900",
            "fax_number": "517-364-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 E MICHIGAN AVE",
            "address_2": "SUITE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122199",
            "telephone_number": "517-364-3900",
            "fax_number": "517-364-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEAVENEY",
        "first_name": "THOMAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301060467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.