Active NPI
Kelly Lynn Keener, D.C.
- Chiropractor
- Milford, DE
National Provider Identifier
1073651055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- F1-0000449
- Practice address
- 375 Mullet Run
Milford, DE 19963-5373 - Phone
- (302) 422-3100
- Fax
- (302) 422-2900
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | F1-0000449 | DE | Primary |
Addresses
Primary practice location
375 Mullet Run
Milford, DE 19963-5373
Mailing address
205 Laristone CT
Providence Hills
Clayton, DE 19938-5504
Phone (302) 223-6886
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3654798 | Other | DE | AETNA |
| 463526 | Other | DE | IBC & HIGHMARK |
| 0149056000 | Other | DE | AMERIHEALTH |
Other names 1
- Kelly Lynn Riddle
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F1-0000449 | DE | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lodes Chiropractic Center PA | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Wilmington, DE
- NPI 1255463626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335744000000",
"number": "1073651055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 LARISTONE CT",
"address_2": "PROVIDENCE HILLS",
"city": "CLAYTON",
"state": "DE",
"postal_code": "199385504",
"telephone_number": "302-223-6886",
"fax_number": "302-422-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 MULLET RUN",
"city": "MILFORD",
"state": "DE",
"postal_code": "199635373",
"telephone_number": "302-422-3100",
"fax_number": "302-422-2900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENER",
"first_name": "KELLY",
"middle_name": "LYNN",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2012-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "DE",
"license": "F1-0000449",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3654798",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC & HIGHMARK",
"identifier": "463526",
"state": "DE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "0149056000",
"state": "DE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "RIDDLE",
"middle_name": "LYNN",
"credential": "DC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.