Lisa Keller, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

97062 Issued in WI

Practice address

1675 Highland Ave
Room P4 4118
Madison, WI 53792-0002

Phone

(608) 890-8198

Fax

(608) 265-9721

NPI assigned

May 29, 2008

Last updated

May 29, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccassel1223925@direct.uwhealth.org
• Direct secure messaging: lkeller5437@direct.uwhealth.org

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.

• University of Wisconsin Medical Foundation, Inc

  • Multi-Specialty Clinic/Center
  • Middleton, WI
  • NPI 1598784555
  Medicare reassignment NPD
• University of Wisconsin Medical Foundation, Inc

  • Health Educator
  • Madison, WI
  • NPI 1487414082
  NPD

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1316105075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 HIGHLAND AVE",
            "address_2": "ROOM P4 4118",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920002",
            "telephone_number": "608-890-8198",
            "fax_number": "608-265-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 HIGHLAND AVE",
            "address_2": "ROOM P4 4118",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920002",
            "telephone_number": "608-890-8198",
            "fax_number": "608-265-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "97062",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "WI",
            "license": "104212-030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Frances Kelleher
• Amanda Marie Keller, OD
• Anne D Keller, LCSW
• Dean R Keller, MD
• Kelly Keller, LPC-IT
• Peyton Glenn Keller, MD
• Rachel Keller
• Jennifer Lynn Kellerhuis, MED, LAT, ATC
• Claire K Kellesvig, LPC-IT
• Amber Davonne Kelley, APSW

• Pediatric Nurse Practitioner in Madison, WI
• Providers in Madison, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.