Active NPI
Luke Michael Keusch, D.D.S.
- Dentist
- Corydon, IN
National Provider Identifier
1639480502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12011481A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122002291 | IN | Order and Referring Only - Dentist | 6406159581 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011481A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Practice Dentistry
- Corydon, IN
- NPI 1609828086
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.