Active NPI
Keeling and Keeling Enterprises LLC
- Community/Behavioral Health Agency
- Poplar Bluff, MO
National Provider Identifier
1194284539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- KEELING AND KEELING ENTERPRISES LLC
- Practice address
- 1910D Greenwood Dr
Poplar Bluff, MO 63901-2430 - Phone
- (573) 840-8404
- NPI assigned
- Mar 15, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandra Keeling, LPC
- Title
- Owner
- Phone
- (573) 840-8404
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1910D Greenwood Dr
Poplar Bluff, MO 63901-2430
Mailing address
1311 Ginger St
Poplar Bluff, MO 63901-2107
Phone (573) 840-8404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 494916802 | Medicaid | MO |
National Provider Directory
National Provider DirectoryLocations
1910 Greenwood Dr
#D
Poplar Bluff, MO 63901
Phone (573) 840-8404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1552608000000",
"number": "1194284539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 GINGER ST",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639012107",
"telephone_number": "573-840-8404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910D GREENWOOD DR",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639012430",
"telephone_number": "573-840-8404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KEELING AND KEELING ENTERPRISES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-15",
"last_updated": "2019-03-15",
"status": "A",
"authorized_official_last_name": "KEELING",
"authorized_official_first_name": "SANDRA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "573-840-8404",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "494916802",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.