DR. KEATON JAMES FLETCHER (DO) – Family Medicine Physician, NPI 1053042408

DR. KEATON JAMES FLETCHER (DO) is a healthcare provider. based in Cave junction, Oregon. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 0542R (OK). The NPI Number for DR. KEATON JAMES FLETCHER (DO) is 1053042408

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. KEATON JAMES FLETCHER (DO)
NPI
1053042408
Phone
(541) 592-4111
Address
25647 Redwood Hwy
Enumeration Date
17 June 2022
Last Update Date
7 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5414724777
Graduation Year
2022 (4 years ago)
PAC ID
7618464157
Group Practice PAC ID
6305747288
Professional Enrollment ID
I20251016004391
Address ID
OR975261051GR1701XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:3State licenses:2Digital endpointsOther names

2,081 FAMILY PRACTICE in OR

Provider Addresses for DR. KEATON JAMES FLETCHER (DO)

  • 25647 Redwood Hwy

    Cave Junction, OR 975239332

    Phone: (541) 592-4111

    Fax: (541) 592-3916

    Type: Location

  • 900 NE 10TH ST

    OKLAHOMA CITY, OK 731045420

    Phone: (405) 271-2230

    Type: Mailing

  • 1701 NW HAWTHORNE AVE

    GRANTS PASS, OR 975261051

    Phone: (541) 472-4777

    Fax: (541) 471-1439

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251016004391IFamily PracticeORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97523)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305747288View full group profile
NameSpecialtyState
-OR
Nurse PractitionerOR
Nurse PractitionerOR
Physician AssistantOR
Clinical Social WorkerOR
Internal MedicineOR
Nurse PractitionerOR
Nurse PractitionerOR
Nurse PractitionerOR
Family PracticeNH

Reviews

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Frequently asked questions

What identifier follows DR. KEATON JAMES FLETCHER (DO) across health systems?
The NPI 1053042408 uniquely identifies DR. KEATON JAMES FLETCHER (DO) in U.S. healthcare data.
Is DR. KEATON JAMES FLETCHER (DO)'s NPI status active today?
Active status means DR. KEATON JAMES FLETCHER (DO)'s NPI record is not deactivated in the public file.
What type of care does DR. KEATON JAMES FLETCHER (DO) provide?
DR. KEATON JAMES FLETCHER (DO)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to DR. KEATON JAMES FLETCHER (DO)?
The directory associates DR. KEATON JAMES FLETCHER (DO) with Cave Junction, Oregon. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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