Organization Active NPI

Keller Eye Center, P.a.

  • Optometrist
  • Emporia, KS
National Provider Identifier
1104174051
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KELLER EYE CENTER, P.A.
Practice address
2301 Industrial Rd
Ste 2020
Emporia, KS 66801-6656
Phone
(620) 343-8876
NPI assigned
Aug 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Dr. Michael Keller, O.D.NPI 1982685699
Title
Owner/Optometrist
Phone
(785) 330-3199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X KS Primary

Addresses

Primary practice location

2301 Industrial Rd
Ste 2020
Emporia, KS 66801-6656

Mailing address

2301 Industrial Rd
Ste 2020
Emporia, KS 66801-6656
Phone (620) 343-8876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150805006986 KS Part B Supplier - Clinic/Group Practice 4082928908 Receives reassigned benefits from 1 practitioner
Practice locations: Emporia, KS

National Provider Directory

National Provider Directory

Locations

2301 Industrial Rd
Ste 2020
Emporia, KS 66801
Phone (620) 343-8876

1501 SW Wanamaker Rd
Ste 700
Topeka, KS 66604

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1104174051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 INDUSTRIAL RD",
            "address_2": "STE 2020",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668016656",
            "telephone_number": "620-343-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 INDUSTRIAL RD",
            "address_2": "STE 2020",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668016656",
            "telephone_number": "620-343-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER EYE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "785-330-3199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.