Shelly D Keller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2009014918 Issued in MO

Practice address

120 Cherokee LN
Lake Winnebago, MO 64034-9304

Phone

(816) 623-9711

NPI assigned

Jul 15, 2009

Last updated

Jul 15, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shelly D Riffle Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• BPH LLC

  dba Behavioral Health Partners

  • Professional Counselor
  • Kansas City, MO
  • NPI 1770989303
  NPD (past)
• John T Bopp PC

  dba Beheavioral Health Partners

  • Clinical Psychologist
  • Kansas City, MO
  • NPI 1447292180
  NPD (past)

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1063642700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CHEROKEE LN",
            "city": "LAKE WINNEBAGO",
            "state": "MO",
            "postal_code": "640349304",
            "telephone_number": "816-623-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CHEROKEE LN",
            "city": "LAKE WINNEBAGO",
            "state": "MO",
            "postal_code": "640349304",
            "telephone_number": "816-623-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SHELLY",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2009014918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "RIFFLE",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Affordable Incontinence
• Megan Bechtold, DPT
• Jessica Fitzgerald, M.S., CCC-SLP
• Full Range Mobile PT, LLC
• Douglas Allen Prager, M.D.
• Jennifer Shoemaker, RN

• Clinical Social Worker in Lake Winnebago, MO
• Providers in Lake Winnebago, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.