Individual provider Active NPI

David M Keuchel, DO

  • Obstetrics & Gynecology Physician
  • Enid, OK
National Provider Identifier
1790785202
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2791 Issued in OK
Practice address
620 S Madison St
Suite 203
Enid, OK 73701-7273
Phone
(580) 237-7280
Fax
(580) 548-1505
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2791 OK Primary

Addresses

Primary practice location

620 S Madison St
Suite 203
Enid, OK 73701-7273

Mailing address

PO Box 5038
Enid, OK 73702-5038
Phone (580) 548-1367

Other identifiers 1

IdentifierTypeStateIssuer
101137230BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040807000139 OK Practitioner - Obstetrics/Gynecology 4486626751 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2791OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority Obstetrics & Gynecology CurrentSince Jan 1, 2014 Accepting new patients
Northwest Oklahoma Cardiovascular Consultants PC Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1411 W 7th Ave
Stillwater, OK 74074
Phone (405) 624-8222

1411 W 7th Ave
Ste 202
Stillwater, OK 74074
Phone (405) 624-8222

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1790785202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5038",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737025038",
            "telephone_number": "580-548-1367",
            "fax_number": "580-548-1537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S MADISON ST",
            "address_2": "SUITE 203",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017273",
            "telephone_number": "580-237-7280",
            "fax_number": "580-548-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEUCHEL",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "2791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101137230B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.