Individual provider Active NPI

Anne D Keller, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1265668933
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
596-123 Issued in WI
Practice address
6510 Grand Teton Plaza
Ste 406
Madison, WI 53719-1029
Phone
(608) 833-9290
Fax
(608) 833-9691
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 596123 WI
Clinical Social Worker 1041C0700X 596-123 WI Primary

Addresses

Primary practice location

6510 Grand Teton Plaza
Ste 406
Madison, WI 53719-1029

Mailing address

6510 Grand Teton Plaza
Ste 406
Madison, WI 53719-1029
Phone (608) 833-9290

Other identifiers 1

IdentifierTypeStateIssuer
1265668933MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
596-123WIMDClinical Social Worker
596123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1265668933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLAZA",
            "address_2": "STE 406",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLAZA",
            "address_2": "STE 406",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ANNE",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "596123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "596-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265668933",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.