Individual provider Active NPI

Keith Marion Keating, D.O.

  • Family Medicine Physician
  • Prescott, AZ
National Provider Identifier
1811029804
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1877 Issued in AZ
Practice address
3607 Crossings Dr Ste B
Prescott, AZ 86305-7149
Phone
(928) 775-2083
Fax
(928) 775-3047
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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 1877 AZ Primary

Addresses

Primary practice location

3607 Crossings Dr Ste B
Prescott, AZ 86305-7149

Mailing address

3607 Crossings Dr Ste B
Prescott, AZ 86305-7149
Phone (928) 775-2083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051103000339 AZ Practitioner - General Practice 2163440678 Practice locations: Prescott, AZ; Prescott Valley, AZ

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3607 Crossing Dr B
Prescott, AZ 86305-7149
Phone (928) 775-2083

3607 Crossings Dr
Suite B
Prescott, AZ 86305-7149

Hospital & facility affiliations

  • Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1877AZMDPhysical Therapist

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1811029804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 CROSSINGS DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057149",
            "telephone_number": "928-775-2083",
            "fax_number": "928-775-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 CROSSINGS DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057149",
            "telephone_number": "928-775-2083",
            "fax_number": "928-775-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATING",
        "first_name": "KEITH",
        "middle_name": "MARION",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.