NPIMap

Individual provider Active NPI

Christopher Jon Keenan, MD

  • Family Medicine Physician
  • Longmont, CO
National Provider Identifier
1851389209
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0034217 Issued in CO
Practice address
601 S Main St
Longmont, CO 80501-6427
Phone
(720) 718-8410
Fax
(720) 718-8999
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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 DR.0034217 CO Primary

Addresses

Primary practice location

601 S Main St
Longmont, CO 80501-6427

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 2

IdentifierTypeStateIssuer
01342179MedicaidCO
029289OtherCOKAISRE COMMERCIAL NUMBER

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address chris.keenan.p4@direct.clinicafamilyhealth.nextgenshare.com Direct
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000016 CO Practitioner - Family Practice 1355344763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

601 S Main St
Primary Care Ken Pratt Blvd
Longmont, CO 80501-6427
Phone (720) 718-8999

Hospital & facility affiliations

  • Optimal Home Care Loveland Home health agency, Loveland, CO, CCN 067546
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128
  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0034217COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services CurrentSince Feb 1, 1995 Accepting new patients
Clinica Campesina Family Health Services Current Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Sep 25, 2023 Accepting new patients
Clinica Campesina Family Health Services PastSince Jun 1, 2020 Accepting new patients
Clinica Campesina Family Health Services Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
#100
Lafayette, CO 80026
Phone (303) 665-2962

1735 S Public Rd
Ste 203
Lafayette, CO 80026

1345 Plaza Ct N
Ste 1A
Lafayette, CO 80026
Phone (303) 665-2962

2000 W South Boulder Rd
Lafayette, CO 80026
Phone 30366530361250

601 S Main St
Longmont, CO 80501
Phone (303) 776-6104

Interoperability endpoints

  • Direct secure messaging: chris.keenan.p4@direct.clinicafamilyhealth.nextgenshare.com
  • Direct secure messaging: chris.keenan.p36@direct.ipn.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1851389209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016427",
            "telephone_number": "720-718-8410",
            "fax_number": "720-718-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0034217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01342179",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISRE COMMERCIAL NUMBER",
            "identifier": "029289",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chris.keenan.p4@direct.clinicafamilyhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGen EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1735 S Public Rd # 100",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800267093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "280 Exempla Cir",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800263370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.