Madelyn M Keck, A.R.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R0039619 Issued in OK

Practice address

302 N Independence Street
Suite 700
Enid, OK 73701-4046

Phone

(580) 249-3066

Fax

(580) 234-5385

NPI assigned

Jun 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1922000280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844737",
            "address_2": "ATTN: IPM CREDENTIALING",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844737",
            "telephone_number": "903-416-1726",
            "fax_number": "903-416-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 N INDEPENDENCE STREET",
            "address_2": "SUITE 700",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014046",
            "telephone_number": "580-249-3066",
            "fax_number": "580-234-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "MADELYN",
        "middle_name": "M",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0039619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500017031",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "444342284001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Klaire Kallas
• Bobby C Kang, D.O.
• Keith Karber
• Dana Nicole Kausek, LCSW
• KD Chiropractic
• Keithly Rehab PLLC
• Alice Keithly
• Kent Allen Keithly, RPT
• Paige Susanna Keithly, PH.D.
• Tiffany A Keitz, S.L.P.

• Nurse Practitioner in Enid, OK
• Providers in Enid, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.