Kathleen Keithley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085-002555 Issued in IL

Practice address

340 W Lincoln St
Belleville, IL 62220-1900

Phone

(618) 233-6044

Fax

(618) 233-3287

NPI assigned

Feb 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Gastroenterology LLCGroup PAC ID 8628121795, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kkeithley222781@directc.mercy.net
• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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

• Mercy Clinic Gastroenterology, LLC

  • Gastroenterology Physician
  • Saint Louis, MO
  • NPI 1528295334
  Medicare reassignment Care Compare group
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  NPD (past)
• Missouri Baptist Medical Center

  • Community/Retail Pharmacy
  • Saint Louis, MO
  • NPI 1154722841
  NPD (past)
• Missouri Baptist Medical Center

  • Community/Retail Pharmacy
  • Saint Louis, MO
  • NPI 1528017266
  NPD (past)
• Missouri Baptist Medical Center

  • Clinical Medical Laboratory
  • Saint Louis, MO
  • NPI 1720696628
  NPD (past)

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

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1760457352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W LINCOLN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201900",
            "telephone_number": "618-233-6044",
            "fax_number": "618-233-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W LINCOLN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201900",
            "telephone_number": "618-233-6044",
            "fax_number": "618-233-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITHLEY",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2003029518",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-002555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdul W Kazi, MD
• Alexander Kazos, M.D.
• KDH & Associates, Inc
• Keli Nicole Keener, MSED, ATC, LAT
• Keeping You Safe Ay Home
• Holly Keller, OTR/L
• Jenna Keller
• Stacey Lynn Keller, PHARM D
• Susan Keller, APN,
• Lauren Katherine Kelly, PA-C

• Medical Physician Assistant in Belleville, IL
• Providers in Belleville, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.