NPIMap

Individual provider Active NPI

Brian Keith Keller, MD

  • Family Medicine Physician
  • Summerville, SC
National Provider Identifier
1215994959
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18014 Issued in SC
Practice address
435 N Cedar St
Summerville, SC 29483-6407
Phone
(843) 873-1592
Fax
(843) 507-8284
NPI assigned
Apr 27, 2006
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18014 SC Primary

Addresses

Primary practice location

435 N Cedar St
Summerville, SC 29483-6407

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other practice location 1

202 Ridge St
Saint George, SC 29477-2446
Phone (843) 563-6000

Other practice location 2

435 N Cedar St
Summerville, SC 29483
Phone (843) 873-1592

Other practice location 3

404 N Pine St
Summerville, SC 29483-6557
Phone (843) 873-0202

Other identifiers 2

IdentifierTypeStateIssuer
080163302OtherSCMEDICARE RAIL ROAD
180146MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031124000240 SC Practitioner - Family Practice 5991609703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

133 E 1St N St
Suite 5
Summerville, SC 29483-6873
Phone (843) 873-1592

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18014SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC Family Medicine Current Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine CurrentSince Oct 22, 2018 Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine CurrentSince Oct 22, 2018 Accepting new patients
Palmetto Primary Care Physicians, LLC Family Medicine Past Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

2500 Elms Center Rd
North Charleston, SC 29406
Phone (763) 348-2075

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

133 E 1st North St
Ste 5
Summerville, SC 29483
Phone (843) 821-2480

201 Oakbrook Ln
Ste 255
Summerville, SC 29485
Phone (843) 851-2000

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

300 W 4th North St
Summerville, SC 29483
Phone (843) 285-7515

404 N Pine St
Summerville, SC 29483
Phone (803) 260-7990

435 N Cedar St
Summerville, SC 29483
Phone (843) 873-1592

Interoperability endpoints

  • Direct secure messaging: brian.keller@ppcp1.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1215994959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N CEDAR ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836407",
            "telephone_number": "843-873-1592",
            "fax_number": "843-507-8284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 Ridge St",
            "address_purpose": "LOCATION",
            "city": "Saint George",
            "state": "SC",
            "postal_code": "294772446",
            "country_code": "US",
            "telephone_number": "843-563-6000",
            "fax_number": "843-563-6015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 N Cedar St",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "29483",
            "country_code": "US",
            "telephone_number": "843-873-1592",
            "fax_number": "843-871-2936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 N Pine St",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294836557",
            "country_code": "US",
            "telephone_number": "843-873-0202",
            "fax_number": "843-832-9409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "080163302",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180146",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.