Bruce W Keppen, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2744 Issued in SD

Practice address

101 Willmar Avenue SW
Affiliated Community Medical Centers
Willmar, MN 56201-3591

Phone

(320) 231-5079

Fax

(320) 231-5067

NPI assigned

Aug 10, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1720089956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVENUE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013591",
            "telephone_number": "320-231-5079",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVENUE SW",
            "address_2": "AFFILIATED COMMUNITY MEDICAL CENTERS",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013591",
            "telephone_number": "320-231-5079",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPPEN",
        "first_name": "BRUCE",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "32303",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SD",
            "license": "2744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5700338",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30114",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1198333",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rutvij Kantharia
• Kristine Dawn Kautzman
• Jarred Kells, LADC, BS
• Jeffrey Robert Kennedy, PT
• Krystal Grace Kennedy, PT, DPT
• David Lawrence Kerski, MD
• Bonnie Kerstein
• Suzanne Marie Keuseman, APRN, CNS-BC, CWOCN
• Steven L Kidd, MD
• Erin Kiecker

• Anesthesiology Physician in Willmar, MN
• Providers in Willmar, MN by specialty
• Anesthesiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.