Active NPI
Jessica Maples Keller, PHD
- Psychologist
- Atlanta, GA
National Provider Identifier
1003308941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY004154
- Practice address
- 12 Executive Park Dr NE Ste 300
Atlanta, GA 30329-2206 - Phone
- (404) 778-2017
- NPI assigned
- Jun 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY004154 | GA | Primary |
Addresses
Primary practice location
12 Executive Park Dr NE Ste 300
Atlanta, GA 30329-2206
Mailing address
2308 Wineleas Rd
Decatur, GA 30033-5519
Phone (630) 701-8590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Networks
- AL HMO
- devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
- devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
- devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
- devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
- AL HMO D-SNP
- devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528243200000",
"number": "1003308941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2308 WINELEAS RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300335519",
"telephone_number": "630-701-8590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 EXECUTIVE PARK DR NE STE 300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292206",
"telephone_number": "404-778-2017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "JESSICA",
"middle_name": "MAPLES",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-06",
"last_updated": "2018-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "PSY004154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.