Matthew Keller

Primary specialty

DentistTaxonomy code 122300000X

License

DN24536 Issued in FL

Practice address

8951 Bonita Beach Rd SE Ste 220
Bonita Springs, FL 34135-4202

Phone

(239) 674-3069

NPI assigned

Sep 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1356990097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 S WAY CT",
            "city": "SALEM",
            "state": "SC",
            "postal_code": "296764625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8951 BONITA BEACH RD SE STE 220",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354202",
            "telephone_number": "239-674-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Wilson MD PA
• Paige McEwen Kayihan, MSW, LICSW
• Pamela Kearney, CCCSLP
• Keenan Chiropractic PA
• Michael Jay Keenan, D.C.
• Kelley Medical Billing, LLC
• Keneally Physical Therapy & Holistic Healing
• Ketamine Health Centers at Bonita Springs, LLC (Ketamine Health Centers)
• Daniela Ketay
• Taylor Keymont

• Dentist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.