Keira Duvernoy, DO, PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101009710 Issued in MI

Legal business name

KEIRA DUVERNOY, DO, PC

Practice address

697 Hannah Ave
Suite D
Traverse City, MI 49686-2201

Phone

(231) 947-0900

NPI assigned

Jan 19, 2011

Organization subpart

No

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

Authorized official

Name

Keira Duvernoy, DO

Title

President

Phone

(231) 947-0900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CENTER FOR INTEGRATIVE MEDICINE, PC Other name

Locations

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1699070870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 HANNAH AVE",
            "address_2": "SUITE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 HANNAH AVE",
            "address_2": "SUITE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862201",
            "telephone_number": "231-947-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEIRA DUVERNOY, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "DUVERNOY",
        "authorized_official_first_name": "KEIRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-947-0900",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101009710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI1",
            "identifier": "1548234180",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER FOR INTEGRATIVE MEDICINE, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Joan Keen, FNP-BC
• Jennifer Keene, MS, OTR/L
• John Charles Keep, MD
• Grace Keilty, LLPC
• Jaclyn N Keiper, CRNA
• Anna Keith, NP
• Carolyn J Keith, MD
• Nichole Kelenske, NP-C
• Jacqueline Keller, LPC
• Jessica Kelley, M.A, LPC

• General Practice Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.