Physician Compare National (NPI:1750579942)

HEALTHCARE PROVIDER: WILLIAM A. KEATES M.D.

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

Individual Professional Information
NPI	1750579942
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971673708
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20131126000696
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KEATES
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	METHODIST HEALTH, INC.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4981508454
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	82
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1305 N ELM ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	HENDERSON
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	424202783
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2708277937
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	180056
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	380004
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE ST VINCENT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	380061
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PROVIDENCE PORTLAND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y