Ethan Frederick Keller, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C7-0018190 Issued in DE

Practice address

804 N Dupont Blvd
Milford, DE 19963-1006

Phone

(302) 725-3557

NPI assigned

Apr 25, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1093403420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S STATE ST # MC3007",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 N DUPONT BLVD",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199631006",
            "telephone_number": "302-725-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ETHAN",
        "middle_name": "FREDERICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C7-0018190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Kaufhold, MS
• Mariam A Kazmi
• Kathleen Drees Keegan
• Kelly Lynn Keener, D.C.
• Allison Kayla Kell, PA-C
• Teresa H Keller, M.D.
• Krystal Kelley
• Jillian Kemmerlin, OTR
• Brooke Allison Devore Kennedy, PA-C
• Janet E Kennedy, CRNA

• Internal Medicine Physician in Milford, DE
• Providers in Milford, DE by specialty
• Internal Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.