Active NPI
David Keller
- Social Worker
- Bad Axe, MI
National Provider Identifier
1346679487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802059138
- Practice address
- 1108 S Van Dyke Rd
Bad Axe, MI 48413-9615 - Phone
- (989) 269-9293
- NPI assigned
- Nov 8, 2013
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802059138 | MI | Primary |
Addresses
Primary practice location
1108 S Van Dyke Rd
Bad Axe, MI 48413-9615
Mailing address
1108 S Van Dyke Rd
P.O. Box 312
Bad Axe, MI 48413-9615
Phone (989) 269-9293
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 |
|---|---|---|---|
| 6802059138 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1346679487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 S VAN DYKE RD",
"address_2": "P.O. BOX 312",
"city": "BAD AXE",
"state": "MI",
"postal_code": "484139615",
"telephone_number": "989-269-9293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 S VAN DYKE RD",
"city": "BAD AXE",
"state": "MI",
"postal_code": "484139615",
"telephone_number": "989-269-9293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-08",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802059138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bad Axe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.