Individual provider Active NPI

William R Keane, MD

  • Specialist
  • Columbia, SC
National Provider Identifier
1811961634
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9543 Issued in SC
Practice address
14 Richland Medical Park
310
Columbia, SC 29203-6877
Phone
(803) 252-9907
Fax
(803) 252-9906
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9543 SC Primary

Addresses

Primary practice location

14 Richland Medical Park
310
Columbia, SC 29203-6877

Mailing address

121 Park Central Dr
200
Columbia, SC 29203-6469
Phone (803) 252-9907

Other identifiers 1

IdentifierTypeStateIssuer
95435MedicaidSC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9543SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Nephrology Associates PA Specialist Current Accepting new patients
Columbia Nephrology Associates PA Current Accepting new patients

Locations

121 Park Central Dr
Ste 200
Columbia, SC 29203
Phone (803) 252-9907

14 Richland Medical Park Dr
Ste 310
Columbia, SC 29203
Phone (803) 252-9907

Organizations & group practices 2

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1811961634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036469",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK",
            "address_2": "310",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036877",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "9543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95435",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.