Dr Daniel Kelderhouse Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34-00-3555 Issued in OH

Legal business name

DR DANIEL KELDERHOUSE INC

Practice address

201 S Park Ave
Fremont, OH 43420-2953

Phone

(419) 334-8941

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Ellen Morris

Title

Office MGR

Phone

(419) 334-8941

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1235318288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S PARK AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202953",
            "telephone_number": "419-334-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S PARK AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202953",
            "telephone_number": "419-334-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DANIEL KELDERHOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "419-334-8941"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-00-3555",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "OH",
            "license": "34-00-3555",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0519782",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fremont, OH
• Providers in Fremont, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.