Individual provider Active NPI

Keith Wayne Kiser, M.D.

  • Family Medicine Physician
  • Sugar Land, TX
National Provider Identifier
1801898218
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G3524 Issued in TX
Practice address
2205 Williams Trace Blvd
#105
Sugar Land, TX 77478-4443
Phone
(281) 980-2722
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G3524 TX Primary

Addresses

Primary practice location

2205 Williams Trace Blvd
#105
Sugar Land, TX 77478-4443

Mailing address

2205 Williams Trace Blvd
#105
Sugar Land, TX 77478-4443
Phone (281) 980-2722

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000463 TX Practitioner - Family Practice 9335289354 Practice locations: Sugar Land, TX

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1801898218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 WILLIAMS TRACE BLVD",
            "address_2": "#105",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784443",
            "telephone_number": "281-980-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 WILLIAMS TRACE BLVD",
            "address_2": "#105",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784443",
            "telephone_number": "281-980-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISER",
        "first_name": "KEITH",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G3524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.