Keith Scott Classen, FNP

Individual provider Active NPI Family Nurse Practitioner · Atmore, AL

NPI 1629545926 · NPPES record last updated Nov 1, 2018

Key facts

NPI
1629545926
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
1-096876 (AL)
Practice address
401 Medical Park Dr
Atmore, AL 36502-3091
Phone
(251) 368-2500
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Escambia County Alabama Community Hospitals, Inc (11 clinicians)

Practice addresses (Care Compare)

401 Medical Park Dr
Atmore, AL 36502-3006
Phone (251) 368-2500

5850 Hwy 21
Atmore, AL 36502-6333
Phone (251) 368-6245

Hospital & facility affiliations

  • Atmore Community Hospital Hospital · Atmore, AL · CCN 010169

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190318000810 AL Practitioner - Nurse Practitioner 2466792122 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Escambia County Alabama Community Hospitals, Inc. Current
since Jan 14, 2019
Accepting new patients
Escambia County Alabama Community Hospitals, Inc Current
since Jan 14, 2019
Accepting new patients
Escambia County Alabama Community Hospitals, Inc. Current
since Jan 14, 2019
Accepting new patients

Locations

5850 Highway 21
Atmore, AL 36502
Phone (251) 368-6245

402 Medical Park Dr
Atmore, AL 36502
Phone (251) 368-6362

401 S 8th Ave
Atmore, AL 36502
Phone (251) 368-2500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-096876 AL Yes

Addresses

Primary practice location

401 Medical Park Dr
Atmore, AL 36502-3091

Mailing address

401 Medical Park Dr
Atmore, AL 36502-3091
Phone (251) 368-2500

Other providers in Atmore, AL

All providers in Atmore, AL · Family Nurse Practitioner in Alabama

Sources for this page

Verify at the official NPI Registry.