DR. JACK C. KEEN M.D.
NPI 1063759652
Specialist in Cresson, TX

Q: What is Jack Keen's NPI number?

The NPI number for Jack Keen is 1063759652. It was assigned to this individual provider in the NPPES registry on January 15, 2013.

Q: What is Jack Keen's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Keen was last updated on January 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 15, 2013PECOS Enrolled

408 STONE MOUNTAIN CT, CRESSON, TX 76035(817) 512-3006 Get Directions Write a Review

NPPES record last updated: January 15, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Jack C. Keen M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK C. KEEN M.D. (NPI 1063759652) is an individual specialist in Cresson, Texas, licensed in Texas (G4144) and active in the NPI registry since January 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063759652

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. JACK C. KEENCredential: M.D.

Location Address408 STONE MOUNTAIN CTCresson, TX 76035-5628

Mailing Address408 Stone Mountain CtCresson, TX 76035-5628 · (817) 512-3006

Phone(817) 512-3006

Sole ProprietorYes

Enumeration DateJanuary 15, 2013

✔ NPI 1063759652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in TX · G4144

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

408 STONE MOUNTAIN CT, Cresson, TX 76035

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack C. Keen M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Keen's NPI number?

The NPI number for Jack Keen is 1063759652. It was assigned to this individual provider in the NPPES registry on January 15, 2013.

Where is Jack Keen located?

Jack Keen practices at 408 Stone Mountain Ct, Cresson, TX 76035. The listed phone number is (817) 512-3006.

What is Jack Keen's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Jack Keen enrolled in Medicare?

Yes. Jack Keen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Keen was last updated on January 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.