Samuel Keller
Individual provider Active NPI Hearing Instrument Specialist · Roeland Park, KS
NPI 1255716643 · NPPES record last updated Mar 11, 2025
Key facts
- NPI
- 1255716643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Hearing Instrument Specialist 237700000X
- License
- KS1615 (KS)
- Practice address
- 5332 Cedar St
Roeland Park, KS 66205-2217 - Phone
- (913) 543-1970
- NPI assigned
- Jul 27, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS1615 | KS | MD | Hearing Instrument Specialist |
| 2017032373 | MO | MD | Hearing Instrument Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 2017032373 | MO | |
| Hearing Instrument Specialist | 237700000X | KS1615 | KS | Yes |
Addresses
Primary practice location
5332 Cedar St
Roeland Park, KS 66205-2217
Mailing address
5332 Cedar St
Roeland Park, KS 66205-2217
Phone (913) 543-1970
Other practice location 1
5332 Cedar St
Roeland Park, KS 66205-2217
Phone (913) 543-1970
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KS1615 | Other | KS | HEARING AID DISPENSER LICENSE |
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- Jennifer L Kennedy
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All providers in Roeland Park, KS · Hearing Instrument Specialist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.