Individual provider Active NPI

Allison Anne Keller, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1225202260
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
5324349-1205 Issued in UT
Practice address
295 Chipeta Way
Salt Lake City, UT 84108-1220
Phone
(801) 587-7450
Fax
(801) 587-7455
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5323439-1205 UT
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 5324349-1205 UT Primary

Addresses

Primary practice location

295 Chipeta Way
Salt Lake City, UT 84108-1220

Mailing address

PO Box 581289
Pediatric Emergency Medicine
Salt Lake City, UT 84158-1289
Phone (801) 587-7450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AKELLER38243@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080918000521 UT Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8921175852 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5324349-1205UTMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Acuity Care CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Services CurrentSince Jul 20, 2020 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Acuity Care Current Accepting new patients
University of Utah Pediatric Services CurrentSince Jul 20, 2020 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients

Locations

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 6

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": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1225202260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581289",
            "address_2": "PEDIATRIC EMERGENCY MEDICINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581289",
            "telephone_number": "801-587-7450",
            "fax_number": "801-587-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081220",
            "telephone_number": "801-587-7450",
            "fax_number": "801-587-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ALLISON",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "5323439-1205",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "UT",
            "license": "5324349-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AKELLER38243@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.