Individual provider Active NPI

Kevin Joel Geller

  • Rehabilitation Practitioner
  • Roseville, CA
National Provider Identifier
1083259881
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
3650 Golden Eagle PL
Roseville, CA 95747-9693
Phone
(913) 904-8204
NPI assigned
Nov 15, 2019
Last updated
May 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

3650 Golden Eagle PL
Roseville, CA 95747-9693

Mailing address

3650 Golden Eagle PL
Roseville, CA 95747-9693
Phone (913) 904-8204

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

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1083259881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 GOLDEN EAGLE PL",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479693",
            "telephone_number": "913-904-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 GOLDEN EAGLE PL",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957479693",
            "telephone_number": "913-904-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLER",
        "first_name": "KEVIN",
        "middle_name": "JOEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.