Individual provider Active NPI

Gary Don Keel, PA-C

  • Medical Physician Assistant
  • Ft. Worth, TX
National Provider Identifier
1801036868
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA02112 Issued in TX
Practice address
#1 Lockheed Blvd.
Lockheed Martin Aeronautics Company
Ft. Worth, TX 76108
Phone
(817) 777-8183
Fax
(817) 777-1956
NPI assigned
Mar 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA02112 TX Primary

Addresses

Primary practice location

#1 Lockheed Blvd.
Lockheed Martin Aeronautics Company
Ft. Worth, TX 76108

Mailing address

3106 Walnut Creek Pkwy
Granbury, TX 76049-7916
Phone (817) 326-5586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA02112TXMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1801036868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 WALNUT CREEK PKWY",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497916",
            "telephone_number": "817-326-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#1 LOCKHEED BLVD.",
            "address_2": "LOCKHEED MARTIN AERONAUTICS COMPANY",
            "city": "FT. WORTH",
            "state": "TX",
            "postal_code": "76108",
            "telephone_number": "817-777-8183",
            "fax_number": "817-777-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEL",
        "first_name": "GARY",
        "middle_name": "DON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.