Jack Keehn, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME162193 Issued in FL

Practice address

2001 Kingsley Ave
Orange Park, FL 32073-5156

Phone

(904) 639-2000

NPI assigned

Apr 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Univ of Central Florida, College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040
• Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent'S Clay County Hospital, Middleburg, FL, CCN 100321
• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
• HCA Florida Orange Park Hospital Hospital, Orange Park, FL, CCN 100226

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America, LLC

  • Emergency Medicine Physician
  • Miramar Beach, FL
  • NPI 1295442614
  Medicare reassignment Care Compare group NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment Care Compare group NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1871280867
  NPD

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

• Memorial Healthcare Group Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation
• Orange Park Medical Center, Inc.

  • General Acute Care Hospital
  • Orange Park, FL
  • NPI 1689611501
  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent'S Medical Center-Clay County, Inc.

  • General Acute Care Hospital
  • Middleburg, FL
  • NPI 1457690471
  Care Compare affiliation
• St. Vincent'S Medical Center, Inc.

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1659900512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 RIVERTON RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735156",
            "telephone_number": "904-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEHN",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME162193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Allen Kasych, M.D.
• Renee Denise Katich
• Ashley Marie Kaufman
• Ahmad Amir Kayali, MD
• Crystle Taiyo Kearley, DPT
• Eric Keelen, PTA
• Kaitlyn Burgess Keen, DMD
• Janel Laura Keener, MD
• Ruth J Keili
• Vasiljana Stathi Kelly, FNP

• Emergency Medicine Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.