Individual provider Active NPI

Keyane Haile, MD

  • Family Medicine Physician
  • Harpers Ferry, WV
National Provider Identifier
1881271377
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0100644 Issued in MD
Practice address
171 Taylor St
Harpers Ferry, WV 25425-3641
Phone
(304) 535-6343
Fax
(304) 535-6618
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X D0100644 MD Primary

Addresses

Primary practice location

171 Taylor St
Harpers Ferry, WV 25425-3641

Mailing address

5935 Bertram Ave
Baltimore, MD 21214-2002
Phone (407) 579-8886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20241206001208 MD Practitioner - Family Practice 7618403171 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0100644MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 2, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 2, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

4000 Garden City Dr
Fl 4
Hyattsville, MD 20785
Phone (227) 229-8532

4920 Campbell Blvd
Nottingham, MD 21236
Phone (410) 933-7600

2101 E Jefferson St
#4E
Rockville, MD 20852

Organizations & group practices 3

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1881271377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 BERTRAM AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142002",
            "telephone_number": "407-579-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 TAYLOR ST",
            "city": "HARPERS FERRY",
            "state": "WV",
            "postal_code": "254253641",
            "telephone_number": "304-535-6343",
            "fax_number": "304-535-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILE",
        "first_name": "KEYANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0100644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harpers Ferry, WV

Sources for this page

Verify at the official NPI Registry.