Matthew Kellough, PRS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

APS.003590 Issued in OH

Practice address

551 E Main St
Lancaster, OH 43130-3809

Phone

(614) 404-6008

NPI assigned

Oct 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1265158273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 243",
            "city": "SUGAR GROVE",
            "state": "OH",
            "postal_code": "431550243",
            "telephone_number": "614-404-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303809",
            "telephone_number": "614-404-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOUGH",
        "first_name": "MATTHEW",
        "credential": "PRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.003590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Keeton
• Danielle Keiper, PSY.D.
• Barbara A Keirns, M.D.
• Lori Ann Keirns
• Quinn Daniel Kelley I
• Arthur Kemerer
• Ginny L. Kemmerer, PHARM.D
• Jennifer Kempton, LPN
• Amanda Kennedy
• George Kennedy Jr.

• Peer Specialist in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.