Individual provider Active NPI

Matthew Keen, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1689124414
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016035658 Issued in MO
Practice address
12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287
Phone
(314) 892-6565
Fax
(314) 892-4828
NPI assigned
Oct 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016035658 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287

Mailing address

12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287
Phone (314) 892-6565

Other practice location 1

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161212001135 MO Practitioner - Nurse Practitioner 3476833369 Reassigns benefits to 5 organizations
I20220503001796 IL Practitioner - Nurse Practitioner 3476833369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital SouthGroup PAC ID 8426962556, 45 clinicians
Mercy Clinic Pulmonology - St. Louis, LLCGroup PAC ID 2365599925, 23 clinicians
Midwest Emergency Anderson Health IncGroup PAC ID 8022401256, 33 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

12700 Southfork Rd
Suite 280
Saint Louis, MO 63128-3287
Phone (314) 892-6565

400 N Caldwell St
Staunton, IL 62088-1173
Phone (618) 635-2022

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital South CurrentSince Jul 21, 2024 Accepting new patients
Mercy Hospital South CurrentSince Jul 21, 2024 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Jan 23, 2023 Accepting new patients
Signify Health, LLC CurrentSince Jul 29, 2024 Accepting new patients
SSM Medical Group, Inc. CurrentSince Oct 24, 2016 Accepting new patients
SSM Medical Group Inc. CurrentSince Oct 24, 2016 Accepting new patients
Midwest Emergency Anderson Health, Inc CurrentSince Feb 1, 2022 Accepting new patients
Midwest Inpatient Anderson Health, Inc CurrentSince Feb 1, 2022 Accepting new patients
Bigeye Emergency Physicians LLC Past Accepting new patients

Locations

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

400 N Caldwell St
Staunton, IL 62088
Phone (618) 635-2200

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1689124414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283287",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283287",
            "telephone_number": "314-892-6565",
            "fax_number": "314-892-4828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEN",
        "first_name": "MATTHEW",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016035658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.