Individual provider Active NPI

Keith Andrew Duerler, P.T.

  • Physical Therapist
  • Lexington, KY
National Provider Identifier
1114099330
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-003352 Issued in KY
Practice address
880 Corporate Dr Ste 202
Lexington, KY 40503-5449
Phone
(859) 797-5513
Fax
(859) 258-8592
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 003352 KY
Sports Physical Therapist 2251S0007X PT-003352 KY
Orthopedic Physical Therapist 2251X0800X PT-003352 KY
Physical Therapist 225100000X PT-003352 KY Primary

Addresses

Primary practice location

880 Corporate Dr Ste 202
Lexington, KY 40503-5449

Mailing address

PO Box 911063
Lexington, KY 40591-1063
Phone (859) 797-5513

Other identifiers 6

IdentifierTypeStateIssuer
ASC1019OtherKYASC MEDICARE GROUP
4000501OtherKYMEDICARE LAB GROUP
37903705OtherKYMEDICAID LAB GROUP
36000818OtherKYASC MEDICAID GROUP
CB5773OtherKYRR GROUP
P00224418OtherKYRR MEDICARE PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091223000445 KY Practitioner - Physical Therapist in Private Practice 8527108521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KLD Therapy PLLCGroup PAC ID 7618017401, 5 clinicians

Practice addresses (Care Compare)

880 Corporate Dr
Suite 202
Lexington, KY 40503-5449
Phone (859) 797-5513

PO Box
Suite 911063
Lexington, KY 40591-1063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-003352KYMDSports Physical Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1114099330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911063",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405911063",
            "telephone_number": "859-797-5513",
            "fax_number": "859-898-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 CORPORATE DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035449",
            "telephone_number": "859-797-5513",
            "fax_number": "859-258-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUERLER",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-07-11",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003352",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "KY",
            "license": "PT-003352",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KY",
            "license": "PT-003352",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT-003352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC MEDICARE GROUP",
            "identifier": "ASC1019",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LAB GROUP",
            "identifier": "4000501",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LAB GROUP",
            "identifier": "37903705",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC MEDICAID GROUP",
            "identifier": "36000818",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP",
            "identifier": "CB5773",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00224418",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.