Individual provider Active NPI

Kevin E Keller, MD

  • Anesthesiology Physician
  • Grand Junction, CO
National Provider Identifier
1083645824
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
45304 Issued in CO
Practice address
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone
(970) 244-2506
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 45304 CO Primary

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-8209

Mailing address

1120 Wellington Ave Ste 206
Grand Junction, CO 81501-6131
Phone (970) 243-7245

Other identifiers 1

IdentifierTypeStateIssuer
46070214MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000119 CO Practitioner - Anesthesiology 2062458524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of Western Colorado, PLLCGroup PAC ID 8921995754, 28 clinicians

Practice addresses (Care Compare)

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45304COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants of Western Colorado, PLLC Anesthesiology CurrentSince Jul 1, 2007 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Anesthesia Consultants of Indianapolis, LLC Anesthesiology Past Accepting new patients

Locations

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

710 Wellington Ave
Grand Junction, CO 81501
Phone (970) 298-7106

1120 Wellington Ave
Ste 206
Grand Junction, CO 81501
Phone (970) 243-7245

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1083645824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WELLINGTON AVE STE 206",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016131",
            "telephone_number": "970-243-7245",
            "fax_number": "970-241-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-244-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KEVIN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "45304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46070214",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.