Michelle Dannette Keck, REGISTERED NURSE

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

0118827 Issued in CO

Practice address

12440 Ellingwood Peak PL
Peyton, CO 80831-4439

Phone

(760) 267-4115

Fax

(719) 524-4075

NPI assigned

May 2, 2006

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1063470771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12440 ELLINGWOOD PEAK PL",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314439",
            "telephone_number": "719-526-7616",
            "fax_number": "719-524-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 ELLINGWOOD PEAK PL",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314439",
            "telephone_number": "760-267-4115",
            "fax_number": "719-524-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "MICHELLE",
        "middle_name": "DANNETTE",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CO",
            "license": "0118827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle.d.keck.civ@mail.mil",
            "affiliation": "N",
            "endpointDescription": "business email",
            "address_1": "12440 Ellingwood Peak Pl",
            "city": "Peyton",
            "state": "CO",
            "country_code": "US",
            "postal_code": "808314439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jay B Johnson, DMD
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• Sabrina Keller
• Ronald Kelly
• Alyssa Kersch, NP
• Kylee Kimball, DPT
• Phillip Graden Kleinman, MSN

• Case Management Registered Nurse in Peyton, CO
• Providers in Peyton, CO by specialty
• Case Management Registered Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.