Individual provider Active NPI

Kelly McKeon

  • Certified Registered Nurse Anesthetist
  • Flint, MI
National Provider Identifier
1841836582
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704327312 Issued in MI
Practice address
303 E Kearsley St
Flint, MI 48502-1907
Phone
(810) 762-3147
NPI assigned
Nov 18, 2019
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704327312 MI Primary

Addresses

Primary practice location

303 E Kearsley St
Flint, MI 48502-1907

Mailing address

303 E Kearsley St
Flint, MI 48502-1907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210921003951 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446657266 Reassigns benefits to 3 organizations
I20241110000078 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446657266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Area Anesthesia PCGroup PAC ID 8628975968, 33 clinicians
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-6000

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704327312MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Genesys Hospital CurrentSince Mar 1, 2022 Accepting new patients
The Digestive Endoscopy Center of Michigan LLC Single Specialty CurrentSince Sep 1, 2021 Accepting new patients
Capital Area Anesthesia PC Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Henry Ford Health Genesys Hospital Single Specialty CurrentSince Mar 1, 2022 Accepting new patients
The Digestive Endoscopy Center of Michigan LLC Current Accepting new patients
Florida Hospital Healthcare Partners, Inc Single Specialty CurrentSince Nov 7, 2024 Accepting new patients

Locations

301 Memorial Medical Pkwy
Daytona Beach, FL 32117
Phone (386) 231-3906

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

7794 Solution Ctr
Chicago, IL 60677

6240 Rashelle Dr
Ste 101
Flint, MI 48507
Phone (810) 600-4000

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

1 Genesys Pkwy
#H
Grand Blanc, MI 48439

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

1749 Hamilton Rd
Ste 102E
Okemos, MI 48864
Phone (517) 482-2118

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1841836582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E KEARSLEY ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E KEARSLEY ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021907",
            "telephone_number": "810-762-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704327312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.