Active NPI
Robert Keller, PA-C
- Medical Physician Assistant
- Toledo, OH
National Provider Identifier
1295821452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601003303
- Practice address
- 3333 Glendale Ave
Toledo, OH 43614-2426 - Phone
- (419) 259-2000
- Fax
- (419) 259-2008
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601003303 | MI | Primary |
Addresses
Primary practice location
3333 Glendale Ave
Toledo, OH 43614-2426
Mailing address
3333 Glendale Ave
Toledo, OH 43614-2426
Phone (419) 259-2000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003303 | MI | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295821452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 GLENDALE AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436142426",
"telephone_number": "419-259-2000",
"fax_number": "419-259-2008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 GLENDALE AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436142426",
"telephone_number": "419-259-2000",
"fax_number": "419-259-2008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601003303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.