DR. MATTHEW S. KEENE (NPI# 1508967621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508967621 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW S. KEENE |
| Credential | DPM |
| Practice Address |
4777 East State Street Suite 8 Rockford IL 61108 |
| Practice Telephone | 8159808980 |
| Practice Fax Number | 8153972266 |
| Mailing Telephone | 8159808980 |
| Mailing Fax Number | 8153972266 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-09-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 016005216 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
016005216 | IL | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016005216 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS BLUE CROSS | 010132351 | 01 |
| IL | 016005216 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184790164 | Matthew S Keene | Psychiatry & Neurology | 12409 W Indian School Rd, C-306, Avondale, AZ 85392-9502 | 2006-11-28 |
| Street Address |
4777 EAST STATE STREET SUITE 8 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790137685 | Shah Foot & Ankle LLC | Podiatrist | 3851 N Mulford Rd, Rockford, IL 61114-5603 | 2016-07-05 |
| 1528455565 | Biren Shah | Podiatrist | 6090 Strathmoor Dr Ste 6, Rockford, IL 61107-5200 | 2015-04-16 |
| 1821481755 | Rps Surgical Ltd | Podiatrist | 1617 Temple Ln, Rockford, IL 61112-1045 | 2015-03-17 |
| 1598985939 | Tina Renee Entwistle | Podiatrist | 6778 Mill Rd, Suite 100, Rockford, IL 61108-2502 | 2007-04-26 |
| 1578658506 | Joseph Thomas Fanara | Podiatrist | 1617 Temple Lane, Rockford, IL 61112-1045 | 2006-10-04 |
| 1427059237 | Flavio Cordano | Podiatrist | 534 Roxbury Rd, Rockford, IL 61107-5076 | 2005-08-02 |
| 1952306045 | Dinesh C Pandya | Podiatrist | 5695 Strathmoor Dr, Ste 1, Rockford, IL 61107-5192 | 2005-06-16 |
| 1992298822 | Joshua Mark Hendricks | Podiatrist | 5666 E State St, Rockford, IL 61108-2425 | 2018-06-14 |
| 1255852877 | Brittany Nicole Wojnicki | Podiatrist | 5666 E State St, Rockford, IL 61108-2425 | 2017-07-05 |
| 1376921072 | Templin & Associates Podiatry P.C. | Podiatrist | 5695 Strathmoor Dr, Suite 1, Rockford, IL 61107-5192 | 2015-05-13 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.