Stewart Keller DO PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

STEWART KELLER DO PA

Practice address

1314 Lake St
Suite 102
Fort Worth, TX 76102-4581

Phone

(817) 348-8333

Fax

(817) 348-8415

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Stewart R Keller, DO

Title

Owner

Phone

(817) 348-8333

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 2

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

• Ann Revard, LCSW

  • Clinical Social Worker
  • Fort Worth, TX
  • NPI 1194996900
  NPD (past)
• Julie Michelle Sheppard, LCSW

  • Clinical Social Worker
  • Burleson, TX
  • NPI 1710905591
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1225080856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 LAKE ST",
            "address_2": "SUITE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024581",
            "telephone_number": "817-348-8333",
            "fax_number": "817-348-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 LAKE ST",
            "address_2": "SUITE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024581",
            "telephone_number": "817-348-8333",
            "fax_number": "817-348-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWART KELLER DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-348-8333",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0003QJ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DE2226",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179056001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominique Stevenson, LVN
• Robert N. Stevenson, M.D.
• Casey Megan Steward, PT, DPT
• Sammantha Steward
• Stewart Dermatology, PLLC
• Selwyn Ronea Stewart Winrow, PSYD
• Alexia Stewart, CPNP-PC
• Andrew Ronaldo Stewart, MD
• Angelene Marcell Stewart, D.O.
• Annie L Stewart, LCSW

• Neurology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.