RAE KEASHLY MD NPI 1497792352

NPI Information

NPI: 1497792352
Provider Name: RAE KEASHLY, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
705 PLEASANT AVE S
PARK RAPIDS, MN
ZIP 56470
Phone: (218) 732-2800
Get Directions

Rae Keashly, MD is a family medicine in Park Rapids, MN with 31 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Rae Keashly, MD NPI is 1497792352. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

705 PLEASANT AVE S
PARK RAPIDS, MN
ZIP 56470-440
Phone: (218) 732-2800
Fax: (218) 732-2857

The NPI 1497792352 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/1/2006 and was last updated on 8/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		38837	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	23Y88KE	OTHER	MINNESOTA	MNBS #
2	23Y87KE	OTHER	MINNESOTA	MNBS #
3	MN100030	OTHER	MINNESOTA	LHS/BANNERHEALTH #
4	904360	OTHER	MINNESOTA	AMERICA'S PPO/ARAZ #
5	140791	OTHER	MINNESOTA	UCARE #
6	14173	OTHER	MINNESOTA	NDBS #
7	G36257	MEDICARE UPIN	MINNESOTA
8	080083977	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	RR MEDICARE #
9	975817800	MEDICAID	MINNESOTA
10	0106547	OTHER	MINNESOTA	MEDICA #
11	0403067	OTHER	MINNESOTA	MEDICA #
12	0106730	OTHER	MINNESOTA	MEDICA #
13	HP25788	OTHER	MINNESOTA	HEALTHPARTNERS #
14	DA9041015676	OTHER	MINNESOTA	PREFERRED ONE #
15	8050	OTHER	MINNESOTA	SIOUX VALLEY #
16	23Y89KE	OTHER	MINNESOTA	MNBS #
17	080004651	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MN MEDICARE #
18	080004650	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MN MEDICARE #
19	080004649	MEDICARE ID-TYPE UNSPECIFIED	MINNESOTA	MN MEDICARE #
20	18686	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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