Keeley Danielle Castillo, MS, RD, LD

Individual provider Active NPI Registered Dietitian · Idabel, OK

NPI 1336095645 · NPPES record last updated Mar 9, 2026

Key facts

NPI
1336095645
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
3330 (OK)
Practice address
902 E Lincoln Rd
Idabel, OK 74745-7337
Phone
(580) 286-2600
NPI assigned
Mar 9, 2026
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 1577
Durant, OK 74702

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260505000777 TX Practitioner - Registered Dietitian Or Nutrition Professional 3779051198 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3330OKMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3330 OK Yes

Addresses

Primary practice location

902 E Lincoln Rd
Idabel, OK 74745-7337

Mailing address

643 Emerson Rd
Broken Bow, OK 74728-6406
Phone (580) 236-9567

Other providers in Idabel, OK

All providers in Idabel, OK · Registered Dietitian in Oklahoma

Sources for this page

Verify at the official NPI Registry.