Individual provider Active NPI

Steven Lee Keogh, D.C.

  • Chiropractor
  • Thief River Falls, MN
National Provider Identifier
1801892922
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1618 Issued in MN
Practice address
1140 Vanrooy Drive
Thief River Falls, MN 56701-2007
Phone
(218) 681-2225
Fax
(218) 681-4655
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1618 MN Primary

Addresses

Primary practice location

1140 Vanrooy Drive
Thief River Falls, MN 56701-2007

Mailing address

1140 Vanrooy Drive
Thief River Falls, MN 56701-2007
Phone (218) 681-2225

Other identifiers 3

IdentifierTypeStateIssuer
645027000OtherMNMEDICAL ASSISTANCE
0909OtherMNPREFEREDONE
00B02ALOtherMNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080724000683 MN Practitioner - Chiropractic 5294808119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altra Care P aGroup PAC ID 9133294366, 2 clinicians

Practice addresses (Care Compare)

1140 Vanrooy Dr
Thief River Falls, MN 56701-3944
Phone (218) 681-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1618MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Altra Care P a CurrentSince Apr 13, 1998 Accepting new patients

Locations

1140 Vanrooy Dr
Thief Rvr Fls, MN 56701
Phone (218) 281-9200

Organizations & group practices 1

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1801892922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 VANROOY DRIVE",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012007",
            "telephone_number": "218-681-2225",
            "fax_number": "218-681-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 VANROOY DRIVE",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012007",
            "telephone_number": "218-681-2225",
            "fax_number": "218-681-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOGH",
        "first_name": "STEVEN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "645027000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFEREDONE",
            "identifier": "0909",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00B02AL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thief River Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.