Individual provider Active NPI

Dustin Wayne Keffer, DO

  • Emergency Medicine Physician
  • Shawnee Mission, KS
National Provider Identifier
1992062129
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
05-38128 Issued in KS
Practice address
9100 W 74TH St
9136762214
Shawnee Mission, KS 66204-4004
Phone
(913) 676-2214
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 05-38128 KS Primary

Addresses

Primary practice location

9100 W 74TH St
9136762214
Shawnee Mission, KS 66204-4004

Mailing address

9100 W 74TH St
9136762214
Shawnee Mission, KS 66204-4004
Phone (913) 676-2214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20150714001858 KS Practitioner - Emergency Medicine 6305159708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City College of Medicine and Surgery, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Physicians South, P.a.Group PAC ID 2860458544, 33 clinicians

Practice addresses (Care Compare)

1301 S Main St
Ottawa, KS 66067-3537
Phone (781) 280-1589

Hospital & facility affiliations

  • Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104
  • Adventhealth Ottawa Hospital, Ottawa, KS, CCN 170014
  • Adventhealth South Overland Park, Inc Hospital, Overland Park, KS, CCN 170208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05-38128KSMDEmergency Medicine Physician

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1992062129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "address_2": "9136762214",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "address_2": "9136762214",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEFFER",
        "first_name": "DUSTIN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "05-38128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

Verify at the official NPI Registry.