Individual provider Active NPI

Steven Laurence Keenholtz, M.D.

  • Infectious Disease Physician
  • Danvers, MA
National Provider Identifier
1841219599
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
45872 Issued in MA
Practice address
140 Commonwealth Ave
Ste 104
Danvers, MA 01923-3629
Phone
(978) 777-6544
Fax
(978) 774-2091
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 45872 MA Primary

Addresses

Primary practice location

140 Commonwealth Ave
Ste 104
Danvers, MA 01923-3629

Mailing address

140 Commonwealth Ave
Ste 104
Danvers, MA 01923-3629
Phone (978) 777-6544

Other identifiers 1

IdentifierTypeStateIssuer
0122866MedicaidMA

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1841219599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COMMONWEALTH AVE",
            "address_2": "STE 104",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233629",
            "telephone_number": "978-777-6544",
            "fax_number": "978-774-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COMMONWEALTH AVE",
            "address_2": "STE 104",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233629",
            "telephone_number": "978-777-6544",
            "fax_number": "978-774-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENHOLTZ",
        "first_name": "STEVEN",
        "middle_name": "LAURENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "45872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122866",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.