Dr. Keith Michael Krist, M.D.
Pediatrics in Fort Walton Beach, FL. Individual provider (NPI-1).
NPI number1790760841
StatusActive
Last updated in NPPESJan 16, 2017
Details
- NPI
- 1790760841
- Entity type
- Individual (NPI-1)
- Name
- Dr. Keith Michael Krist
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 13, 2005
- Last updated
- Jan 16, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | ME85707 | FL | Yes |
Practice location
1005 Mar Walt DrivePediatric Department
Fort Walton Beach, FL 32547
Phone 850-863-8203 · Fax 850-862-0977
Mailing address
1005 Mar Walt DrivePediatric Department
Fort Walton Beach, FL 32547
Phone 850-863-8203 · Fax 850-862-0977
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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