Marc I Keller, M.D,

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

02.0005602 Issued in VT

Practice address

206 Summit St
Burlington, VT 05401

Phone

(802) 862-3239

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northeastern Vermont Regional Hospital Inc

  • Specialist
  • St Johnsbury, VT
  • NPI 1760773774
  NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1013430511
  NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1326081811
  NPD
• Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
  • NPI 1548202690
  NPD
• Clearchoicemd Primary Care PLLC

  • Family Medicine Physician
  • Saint Albans, VT
  • NPI 1326582529
  NPD (past)
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  NPD (past)
• Littleton Hospital Association

  • Durable Medical Equipment & Medical Supplies
  • Littleton, NH
  • NPI 1174398846
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1124039128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SUMMIT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013900",
            "telephone_number": "802-862-3239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SUMMIT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-862-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MARC",
        "middle_name": "I",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "VT",
            "license": "042.0005602",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "02.0005602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004733",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30010121",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William A. Keithcart, MA, LADC
• Julie Anne Kelbert, CRNA
• Erin Kellar, MS, AAP
• Barbara Keller, LCMHC
• Gary Aron Keller, M.D.
• Ray Eugene Keller, M.D.
• Sheryl Peterson Keller, MD
• Kyle James Kellett
• Brian Kelley, APRN-BC,MSN
• Cathleen M Kelley, LICSW

• Internal Medicine Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Internal Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.