Individual provider Active NPI

Caroline S Keller, M.D.

  • Obstetrics & Gynecology Physician
  • Charleston, SC
National Provider Identifier
1306941935
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
14994 Issued in SC
Practice address
2097 Henry Tecklenburg Dr Ste 312W
Charleston, SC 29414-5744
Phone
(843) 789-1800
Fax
(843) 606-8036
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 14994 SC Primary

Addresses

Primary practice location

2097 Henry Tecklenburg Dr Ste 312W
Charleston, SC 29414-5744

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 2

IdentifierTypeStateIssuer
149949MedicaidSC
P00998183OtherSCRAILROAD MEDICARE ID-RSFPN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090519000319 SC Practitioner - Obstetrics/Gynecology 5395799639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14994SCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Jul 20, 2010 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network Obstetrics & Gynecology CurrentSince Jul 20, 2010 Accepting new patients
Palmetto OB/GYN Physicians, PA Past Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients
Carolina Womens Care PA Obstetrics & Gynecology Past Accepting new patients
Roper Saint Francis Physicians Network Obstetrics & Gynecology Past Accepting new patients

Locations

1 S Park Cir
Ste 400
Charleston, SC 29407
Phone (843) 789-1651

2097 Henry Tecklenburg Dr
Ste 322
Charleston, SC 29414
Phone (843) 606-7246

2097 Henry Tecklenburg Dr
Ste 312W
Charleston, SC 29414
Phone (843) 769-5620

2145 Henry Tecklenburg Dr
Ste 270
Charleston, SC 29414
Phone (843) 577-0220

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20947/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1306941935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 HENRY TECKLENBURG DR STE 312W",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145744",
            "telephone_number": "843-789-1800",
            "fax_number": "843-606-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "CAROLINE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "14994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149949",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID-RSFPN",
            "identifier": "P00998183",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.