Active NPI
Raymond Walter Keller Jr., DO
- Family Medicine Physician
- Marmora, NJ
National Provider Identifier
1013437789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OT018072
- Practice address
- 9 Cindy LN
Marmora, NJ 08223-1169 - Phone
- (609) 536-9864
- NPI assigned
- Jun 23, 2017
- Last updated
- Sep 15, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OT018072 | PA | Primary |
Addresses
Primary practice location
9 Cindy LN
Marmora, NJ 08223-1169
Mailing address
9 Cindy LN
Marmora, NJ 08223-1169
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT018072 | Other | PA | PA STATE TRAINING LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT018072 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spread Med | Current | Accepting new patients | |
| Delmarva Medical Staffing | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Community Health Clinic/Center
- Marmora, NJ
- NPI 1487324034
-
dba Nurse Next Door Delaware
- Home Health Agency
- Georgetown, DE
- NPI 1528774965
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631664000000",
"number": "1013437789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CINDY LN",
"city": "MARMORA",
"state": "NJ",
"postal_code": "082231169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 CINDY LN",
"city": "MARMORA",
"state": "NJ",
"postal_code": "082231169",
"telephone_number": "609-536-9864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "RAYMOND",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-23",
"last_updated": "2021-09-15",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OT018072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA STATE TRAINING LICENSE",
"identifier": "OT018072",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marmora, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.