Individual provider Active NPI

Keith M Duryea, CNS

  • Clinical Nurse Specialist
  • San Angelo, TX
National Provider Identifier
1932173473
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
525231 Issued in TX
Practice address
102 N Magdalen St
San Angelo, TX 76903-5400
Phone
(325) 658-1511
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 525231 TX Primary

Addresses

Primary practice location

102 N Magdalen St
San Angelo, TX 76903-5400

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 1

IdentifierTypeStateIssuer
088296101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1932173473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N MAGDALEN ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035400",
            "telephone_number": "325-658-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURYEA",
        "first_name": "KEITH",
        "middle_name": "M",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "525231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088296101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.