Individual provider Active NPI

Thomas Vernon Keller, D.C

  • Chiropractor
  • Los Banos, CA
National Provider Identifier
1265718316
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
10731 Issued in CA
Practice address
2101 South 10TH Street
Los Banos, CA 93635-5006
Phone
(209) 826-9553
Fax
(209) 826-9553
NPI assigned
Nov 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 10731 CA Primary

Addresses

Primary practice location

2101 South 10TH Street
Los Banos, CA 93635-5006

Mailing address

2101 South 10TH Street
Los Banos, CA 93635-5006
Phone (209) 826-9553

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10731CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1265718316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 SOUTH 10TH STREET",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936355006",
            "telephone_number": "209-826-9553",
            "fax_number": "209-826-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 SOUTH 10TH STREET",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936355006",
            "telephone_number": "209-826-9553",
            "fax_number": "209-826-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "THOMAS",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "10731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.