Individual provider Active NPI

Kristin Keller, AGNP-BC

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1285087676
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71006350A Issued in IN
Practice address
8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954
Phone
(317) 338-7780
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 71006350A IN Primary

Addresses

Primary practice location

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Mailing address

8424 Naab Rd Ste 1L
Indianapolis, IN 46260-1954

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristin.keller.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803001162 IN Practitioner - Nurse Practitioner 3476847187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

8424 Naab Rd
Indianapolis, IN 46260-1954

8433 Harcourt Rd
Suite 100
Indianapolis, IN 46260-2193
Phone (317) 583-7600

Hospital & facility affiliations

  • Ascension at Home Home health agency, Indianapolis, IN, CCN 157083
  • Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
  • Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157
  • Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71006350AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Jul 31, 2017 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jul 31, 2017 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

8424 Naab Rd
Bldg 1
Indianapolis, IN 46260
Phone (317) 338-7431

8424 Naab Rd
Ste 1L
Indianapolis, IN 46260
Phone (317) 338-7780

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

Interoperability endpoints

  • Direct secure messaging: kristin.keller.1@7598.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1285087676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 NAAB RD STE 1L",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601954",
            "telephone_number": "317-338-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KRISTIN",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71006350A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristin.keller.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8424 Naab Rd Ste 1L",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.