Mari Ann Keithahn, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

111416 Issued in MO

Practice address

105 N Keene St Ste 102
Columbia, MO 65201-8131

Phone

(573) 777-8738

Fax

(573) 777-8739

NPI assigned

Nov 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Ophthalmology

Education

Duke University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Missouri Retina Consultants PC

  • Retina Specialist (Ophthalmology) Physician
  • Columbia, MO
  • NPI 1659971620
  Medicare reassignment NPD Authorized official
• Nova Health Medical Group, LLC

  • Internal Medicine Physician
  • Columbia, MO
  • NPI 1366946832
  NPD
• Columbia Orthopaedic Group, LLP

  • Orthopaedic Surgery Physician
  • Columbia, MO
  • NPI 1851392542
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1902880313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-777-8738",
            "fax_number": "573-777-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N KEENE ST STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018131",
            "telephone_number": "573-777-8738",
            "fax_number": "573-777-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITHAHN",
        "first_name": "MARI",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2021-06-29",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "111416",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "111416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "101298",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208468504",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Ann Keeney, LMT
• Keeping Good Company Senior Care at Home, LLC
• Emma S Keicher, M.ED., BCBA
• Debbie Ann Keisker, LCSW
• Victoria Keitel
• Stephen T Keithahn, M.D.
• Betsy Jo Keithley, PT
• Anna Maria Kelleher, RD, LD
• Olivia Keller-Baruch
• Morgan Keller

• Ophthalmology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.
• 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.