Active NPI
Nicholas Keefer, DDS
- Dentist
- Indianapolis, IN
National Provider Identifier
1962079640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12014516A
- Practice address
- 9002 N Meridian St Ste 222
Indianapolis, IN 46260-5350 - Phone
- (317) 699-8754
- NPI assigned
- Jun 9, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9900 | SC | |
| Dentist | 122300000X | 12014516A | IN | Primary |
Addresses
Primary practice location
9002 N Meridian St Ste 222
Indianapolis, IN 46260-5350
Mailing address
7116 Seton House LN
Charlotte, NC 28277-4515
Phone (704) 280-7613
Other practice location 1
140 Leisure Ln
Columbia, SC 29210-4125
Phone (803) 772-9628
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12014516A | IN | MD | Dentist |
| 9900 | SC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1962079640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7116 SETON HOUSE LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282774515",
"telephone_number": "704-280-7613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9002 N MERIDIAN ST STE 222",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462605350",
"telephone_number": "317-699-8754"
}
],
"practiceLocations": [
{
"address_1": "140 Leisure Ln",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292104125",
"country_code": "US",
"telephone_number": "803-772-9628",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEEFER",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-09",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "9900",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12014516A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.