Individual provider Active NPI

Luke Michael Keusch, D.D.S.

  • Dentist
  • Corydon, IN
National Provider Identifier
1639480502
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011481A Issued in IN
Practice address
439 E Chestnut St
Corydon, IN 47112-1203
Phone
(812) 630-0493
NPI assigned
Jun 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011481A IN Primary
General Practice Dentistry 1223G0001X 12011481A IN

Addresses

Primary practice location

439 E Chestnut St
Corydon, IN 47112-1203

Mailing address

439 E Chestnut St
Corydon, IN 47112-1203
Phone (812) 738-2287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160122002291 IN Order and Referring Only - DentistPractitioner - Dentist 6406159581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011481AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Day Dental PC General Practice Past Accepting new patients

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1639480502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 E CHESTNUT ST",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121203",
            "telephone_number": "812-738-2287",
            "fax_number": "812-738-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 E CHESTNUT ST",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121203",
            "telephone_number": "812-630-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEUSCH",
        "first_name": "LUKE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011481A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011481A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.