Active NPI
John A Keegan, D.O.
- Obstetrics & Gynecology Physician
- Burnsville, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 60476
- Practice address
- 14101 Fairview Dr
Burnsville, MN 55337-4590 - Phone
- (952) 993-3282
- NPI assigned
- Oct 20, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 40890 | WI | |
| Obstetrics & Gynecology Physician | 207V00000X | 60476 | MN | Primary |
Addresses
Primary practice location
14101 Fairview Dr
Burnsville, MN 55337-4590
Mailing address
14101 Fairview Dr
Burnsville, MN 55337-4590
Other practice location 1
900 Illinois Ave
Stevens Point, WI 54481-3114
Phone (715) 342-7500
Other practice location 2
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2024 | Other | INTERNAL ID-MOTOR VEHICLE ID | |
| 30090500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40890 | WI | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients |
Locations
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
5200 Fairview Blvd
Ste 1300
Wyoming, MN 55092
Phone (651) 982-7600
5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1538112230
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1932281763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14101 FAIRVIEW DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553374590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14101 FAIRVIEW DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553374590",
"telephone_number": "952-993-3282"
}
],
"practiceLocations": [
{
"address_1": "900 Illinois Ave",
"address_purpose": "LOCATION",
"city": "Stevens Point",
"state": "WI",
"postal_code": "544813114",
"country_code": "US",
"telephone_number": "715-342-7500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5200 Fairview Blvd",
"address_purpose": "LOCATION",
"city": "Wyoming",
"state": "MN",
"postal_code": "550928013",
"country_code": "US",
"telephone_number": "651-982-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEEGAN",
"first_name": "JOHN",
"middle_name": "A",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WI",
"license": "40890",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MN",
"license": "60476",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "2024",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30090500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.