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

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