Physician Compare National (NPI:1154570844)

HEALTHCARE PROVIDER: BROOKE KEELEY DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154570844
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8628247913
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121002000252
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KEELEY
	Individual professional last name
Provider First Name	BROOKE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	360 KINGSTOWN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 106
	Group Practice or individual's line 2 address
City	NARRAGANSETT
	Group Practice or individual's city
State	RI
	Group Practice or individual's state
Zip Code	028823239
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	410008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTH COUNTY HOSPITAL INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	410006
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NEWPORT HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y