Active NPI
Michael G Keeker, MD
- Family Medicine Physician
- Escanaba, MI
National Provider Identifier
1881689248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301058000
- Practice address
- 610 S Lincoln Rd
Escanaba, MI 49829-1215 - Phone
- (906) 786-6488
- Fax
- (906) 786-6409
- NPI assigned
- Sep 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301058000 | MI | Primary |
Addresses
Primary practice location
610 S Lincoln Rd
Escanaba, MI 49829-1215
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
2001 Minneapolis Avenue
Suite D
Gladstone, MI 49837
Phone (906) 428-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3061707 | Medicaid | MI | |
| 080051420 | Other | MI | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230314001949 | MI | Order and Referring Only - Family Practice | 1557400710 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- mkeeker62515@direct.thedacare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1881689248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 S LINCOLN RD",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498291215",
"telephone_number": "906-786-6488",
"fax_number": "906-786-6409"
}
],
"practiceLocations": [
{
"address_1": "2001 Minneapolis Avenue",
"address_2": "Suite D",
"address_purpose": "LOCATION",
"city": "Gladstone",
"state": "MI",
"postal_code": "49837",
"country_code": "US",
"telephone_number": "906-428-2000",
"fax_number": "906-466-2067",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEEKER",
"first_name": "MICHAEL",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301058000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3061707",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080051420",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.