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

Keith Emory Basham, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1124329339

Keith Emory Basham, PHYSICIANASSISTANT is a Physician Assistant in Albuquerque, New Mexico. Qualified in 2010, 16 years ago. Practices with First Choice Community Healthcare, Inc, a 50-clinician group and accepts Medicare assignment. Licensed in Colorado and New Mexico.

Years since qualifying
16
Licensed in
CO, NM
In the registry since
2010
Specialties on file
2
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Practice location Address checks out

7704 2nd St NW Ste A
Albuquerque, NM 87107-6755
Phone: (505) 873-7400
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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 PA2011-0057 (NM)
Physician Assistant Taxonomy 363A00000X · Licence 3117 (CO)

Record details

NPI number1124329339
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedNovember 4, 2010
Last updated in NPPESMay 16, 2025
Certification dateMay 16, 2025
Mailing address2001 Centro Familiar Blvd Sw, Albuquerque, NM 87105-4592

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice First Choice Community Healthcare, Inc. — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Albuquerque