Individual provider Active NPI

Jennifer Lynn Keefer, M.D.

  • Internal Medicine Physician
  • Ballston Spa, NY
National Provider Identifier
1902068679
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
258154 Issued in NY
Practice address
6010 County Farm Rd
Ballston Spa, NY 12020-2207
Phone
(518) 885-6761
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 258154 NY Primary

Addresses

Primary practice location

6010 County Farm Rd
Ballston Spa, NY 12020-2207

Mailing address

6010 County Farm Rd
Ballston Spa, NY 12020-2207
Phone (518) 885-6761

Other identifiers 1

IdentifierTypeStateIssuer
03253990MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220312000218 NY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3779770656

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1902068679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 COUNTY FARM RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120202207",
            "telephone_number": "518-885-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 COUNTY FARM RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120202207",
            "telephone_number": "518-885-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "258154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03253990",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

Verify at the official NPI Registry.