Robert W Keen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102964 Issued in NC

Practice address

145 Kimel Park Dr
Suite 330
Winston Salem, NC 27103-6984

Phone

(336) 765-6181

Fax

(336) 765-8492

NPI assigned

May 22, 2006

Last updated

Sep 9, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolinas Pain Institute, PA

  • Pain Medicine Physician
  • Winston Salem, NC
  • NPI 1376598268
  NPD (past)
• Southeastern Orthopaedic Specialists

  dba Sports Medicine and Orthopaedic Center

  • Orthopaedic Surgery Physician
  • High Point, NC
  • NPI 1437338571
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1679527543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 330",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-765-6181",
            "fax_number": "336-765-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 330",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036984",
            "telephone_number": "336-765-6181",
            "fax_number": "336-765-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102964",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "102964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkeen424451@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "145 Kimel Park Dr",
            "address_2": "Suite 330",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joanna W Kee-Sampson, MD
• Shannon Michelle Keef, NP
• Johnathan L Keefe
• Kaitlyn Keegan
• Jack Steven Keeley, MD
• Kelsey Keenan, MS, RD, LDN
• Chloe Alexis Keeve
• Danielle Surrells Keever, NP
• Kristi Lyn Kehoe, PA-C
• Matthew Kelly Keider

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.

Verify at the official NPI Registry.