Individual provider Active NPI

Toni Marie Keller, PA-C

  • Physician Assistant
  • Columbia, MD
National Provider Identifier
1033340476
Registry record updated Jul 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0000528 Issued in MD
Practice address
5755 Cedar LN
Columbia, MD 21044
Phone
(410) 720-8000
Fax
(410) 740-7511
NPI assigned
Aug 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0000528 MD Primary

Addresses

Primary practice location

5755 Cedar LN
Columbia, MD 21044

Mailing address

5755 Cedar LN
Columbia, MD 21044-2912
Phone (410) 720-8000

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531526400000",
    "number": "1033340476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442912",
            "telephone_number": "410-720-8000",
            "fax_number": "410-740-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-720-8000",
            "fax_number": "410-740-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "TONI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2018-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0000528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.