Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keeley Diane Lantrip

Individual provider Physician Assistant · NPI 1811524945

Keeley Diane Lantrip is a Physician Assistant in Fort Worth, Texas. Qualified in 2020, 6 years ago. Practices with Radiology and Imaging Consultants PC, a 46-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2020
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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4941
Phone: (817) 321-0404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA13694 (TX)

Record details

NPI number1811524945
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 26, 2020
Last updated in NPPESMarch 25, 2024
Certification dateMarch 25, 2024
Mailing address816 W Cannon St, Fort Worth, TX 76104-3146

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Radiology And Imaging Consultants Pc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fort Worth