Missouri Retina Consultants PC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

MISSOURI RETINA CONSULTANTS PC

Practice address

105 N Keene St Ste 102
Columbia, MO 65201-8131

Phone

(573) 777-8738

Fax

(573) 777-8739

NPI assigned

Oct 29, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mari Ann Zeiler Keithahn, MDNPI 1902880313

Title

Owner

Phone

(573) 777-8738

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mari Ann Keithahn, M.D.

  • Ophthalmology Physician
  • Columbia, MO
  • NPI 1902880313

  Retina Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1659971620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-777-8738",
            "fax_number": "573-777-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-777-8738",
            "fax_number": "573-777-8739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 S Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Kirksville",
            "state": "MO",
            "postal_code": "635013703",
            "country_code": "US",
            "telephone_number": "573-777-8738",
            "fax_number": "573-777-8739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSOURI RETINA CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2022-09-19",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "KEITHAHN",
        "authorized_official_first_name": "MARI",
        "authorized_official_middle_name": "ANN ZEILER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-777-8738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkeithahn@moretina.intellechartdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "105 N Keene St Ste 102",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652018131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Retina Specialist (Ophthalmology) Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Retina Specialist (Ophthalmology) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.