Individual provider Active NPI

Dekker Nolan McKeever, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Port Angeles, WA
National Provider Identifier
1801112651
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
60673015 Issued in WA
Practice address
907 Georgiana St
Port Angeles, WA 98362-3911
Phone
(360) 565-0999
Fax
(360) 457-1599
NPI assigned
Apr 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 60673015 WA Primary

Addresses

Primary practice location

907 Georgiana St
Port Angeles, WA 98362-3911

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 417-7111

Other practice location 1

103 W Cedar St
Sequim, WA 98382-3318
Phone (360) 775-2872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710002613 TX Practitioner - Podiatry 9931395118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4848CAMDOptometrist
60673015WAMDFoot & Ankle Surgery Podiatrist
2014NVMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Slope Native Association LTD Current Accepting new patients
Comprehensive Urgent Care Past Accepting new patients
Cambridge Foot and Ankle Associates Inc. Past Accepting new patients
North Olympic Family Practice PastSince Jul 2, 2001 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4399/brand/8/csg/41/fhir/r4

Organizations & group practices 4

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1801112651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620146",
            "telephone_number": "360-417-7111",
            "fax_number": "360-457-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 GEORGIANA ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623911",
            "telephone_number": "360-565-0999",
            "fax_number": "360-457-1599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 W Cedar St",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983823318",
            "country_code": "US",
            "telephone_number": "360-775-2872",
            "fax_number": "855-715-6179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEEVER",
        "first_name": "DEKKER",
        "middle_name": "NOLAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "60673015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.