Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1760960462 Individual Practitioner Male Practitioner

Sid Christian Keomanivong

Nurse Practitioner - Primary Care • Central Point, OR

Professional Overview & Biography Verified Profile Summary

Sid Keomanivong is a registered healthcare professional specializing in Nurse Practitioner - Primary Care in Central Point, OR. Practice services are available at 2677 BEALL LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2677 Beall Ln

Central Point, OR 975021462

Telephone 7023430466

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Primary Care in Central Point, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.0 Yrs
State Avg: 7.7 Yrs
Regional Practice Density
3 Specialists

Practicing in Central Point, OR (110 Statewide)

Telehealth Adoption Rate
33.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Nurse Practitioner - Primary Care Primary Specialty

NUCC Taxonomy Code: 363LP2300X

State License OR 201806379NP-PP

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address October 08, 2019

Registered at 3344 WINTERHAVEN ST, UNIT 101, LAS VEGAS, NV 891085064 (Tel: 7023430466)

NPI Profile Active August 03, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location August 03, 2018

Registered at 2677 BEALL LN, CENTRAL POINT, OR 975021462 (Tel: 7023430466)

📍
Updated Business Mailing Address August 03, 2018

Registered at 2677 BEALL LN, CENTRAL POINT, OR 975021462 (Tel: 7023430466)

👤
Provider Name / Credentials Updated August 03, 2018

Recorded as SID KEOMANIVONG

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2018

Nurse Practitioner (License #201806379NP-PP in OR)

🟢
Initial NPI Registration & Enumeration August 03, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760960462
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 03, 2018
Last Update: October 08, 2019
Sole Proprietor: No

Mailing Address

3344 Winterhaven St, Unit 101

Las Vegas, NV 891085064

Phone: 7023430466

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.