Individual provider Active NPI

Keegan Anne Michel, MD

  • Emergency Medicine Physician
  • Valdosta, GA
National Provider Identifier
1992169692
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
81765 Issued in GA
Practice address
2501 N Patterson St
Valdosta, GA 31602-1735
Phone
(229) 245-6202
NPI assigned
Apr 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301118848 MI
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 81765 GA Primary

Addresses

Primary practice location

2501 N Patterson St
Valdosta, GA 31602-1735

Mailing address

655 W 8TH Street, Box C-506
Jacksonville, FL 32209
Phone (904) 244-3817

Other practice location 1

655 W 8th St # C506
Jacksonville, FL 32209-6511
Phone (904) 244-3817

Other practice location 2

825 N Center Ave
Gaylord, MI 49735-1592
Phone (989) 731-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190211002664 GA Practitioner - Emergency Medicine 3173804184 Reassigns benefits to 1 organization
I20190729003256 MI Practitioner - Emergency Medicine 3173804184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians
Hawk Emergency Group, P.C.Group PAC ID 6800241050, 55 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

825 N Ctr Ave
Gaylord, MI 49735-1592
Phone (989) 731-2100

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81765GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawk Emergency Group, P.C. Emergency Medicine CurrentSince Jan 8, 2024 Accepting new patients
South Georgia Emergency Medicine Associates PC Emergency Medicine CurrentSince Nov 25, 2019 Accepting new patients
Northwestern Michigan Emergency Physicians PC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Interlochen Emergency Group, P.C. Emergency Medicine CurrentSince Mar 9, 2025 Accepting new patients
Traverse Observation Physician Services PC Emergency Medicine Past Accepting new patients

Locations

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 5

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 2

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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1992169692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH STREET, BOX C-506",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-244-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-245-6202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St # C506",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-3817",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 N Center Ave",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351592",
            "country_code": "US",
            "telephone_number": "989-731-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "KEEGAN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301118848",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "81765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.