IndividualActive
Keaton Rider
NPI 1083369938 · Independent Duty Medical Technicians · Cannon Afb, NM
Keaton Rider is a Independent Duty Medical Technicians provider in Cannon Afb, NM (NPI 1083369938).
Provider details
- NPI number
- 1083369938
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- L5ALJ4N051C00AB (TX)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
104 W D.l. Ingram Ave
Cannon Afb, NM 88101
Phone: (575) 784-2778
Approximate (ZIP-level) locationGet directions
Mailing address
6948 Campos Ave Unit B
Jber, AK 99506-3423
Registry dates
- Enumerated
- 2022-02-18
- Last updated
- 2022-08-02
- Certified
- 2022-07-21
Frequently asked questions
- What is Keaton Rider's NPI number?
- Keaton Rider's National Provider Identifier (NPI) is 1083369938, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Keaton Rider's specialty?
- Keaton Rider is listed in the NPPES registry with a primary specialty of Independent Duty Medical Technicians (Other Service Providers).
- Where is Keaton Rider located?
- Keaton Rider's practice location on file with NPPES is 104 W D.l. Ingram Ave, Cannon Afb, NM 88101.
- What is Keaton Rider's phone number?
- The practice phone number listed in the NPPES registry for Keaton Rider is (575) 784-2778.
- Is Keaton Rider's NPI active?
- Yes — Keaton Rider's NPI (1083369938) is active in the NPPES registry as of the last update on 2022-08-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.