Scott Robert Keller, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.132786 Issued in IL

Practice address

3 Park PL
Swansea, IL 62226-2965

Phone

(618) 222-9244

Fax

(618) 222-9248

NPI assigned

Feb 25, 2007

Last updated

Oct 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: skeller24670@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SSM Depaul Medical Group, Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Maryland Heights, MO
  • NPI 1760456743

  Pediatrics

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1003942145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PARK PL",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262965",
            "telephone_number": "618-222-9244",
            "fax_number": "618-222-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PARK PL",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262965",
            "telephone_number": "618-222-9244",
            "fax_number": "618-222-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-25",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2007011139",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2004014306",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.132786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill A Johnston, M.D.
• Bart Aaron Jones, M.D.
• Ashley Jordan, MS, OTR/L
• Eunice Jurcich, COTA/L
• Leslie Nicole Keener
• Carrie Anne Kempf, MOTR/L
• Mary Elizabeth M Kennedy, LCPC
• KH Counseling
• Dan Khampraseut, D.C.
• Melissa Schleeper Kiel, M.D.

• Pediatrics Physician in Swansea, IL
• Providers in Swansea, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.