Amy J Keller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06001615A Issued in IN

Practice address

3211 E Moores Pike
Bloomington, IN 47401-7129

Phone

(812) 334-7604

Fax

(812) 334-7705

NPI assigned

Nov 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1322352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322352000000",
    "number": "1285901884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8279 S STONE RIDGE RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474019037",
            "telephone_number": "812-824-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 E MOORES PIKE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474017129",
            "telephone_number": "812-334-7604",
            "fax_number": "812-334-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "AMY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-27",
        "last_updated": "2011-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06001615A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Keith, RBT
• Jennifer Keith, PA
• Rebecca Anne Keith, M.D.
• Cassandra L. Kellams
• Jennifer Kellams
• Matthew Keller, OD
• Olivia Keller
• Walt Keller, HSPP
• Bethany Lyndsey Kelley
• Michelle Kelley, RBT

• Physical Therapy Assistant in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.