Active NPI
Phelo Joseph Keller, OTSC
- Other Specialist/Technologist
- Morgan City, LA
National Provider Identifier
1366505612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- NBCOT981110
- Practice address
- 1300 Lakewood Dr Suite D
Morgan City, LA 70380 - Phone
- (985) 384-7900
- Fax
- (985) 384-8049
- NPI assigned
- Dec 18, 2006
- 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 |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | NBCOT981110 | LA | Primary |
Addresses
Primary practice location
1300 Lakewood Dr Suite D
Morgan City, LA 70380
Mailing address
PO Box 2375
Morgan City, LA 70381
Phone (985) 384-7900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 950290 | Other | OTC NATIONAL | |
| 981110 | Other | LA | NBCOT |
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 |
|---|---|---|---|
| NBCOT981110 | LA | MD | Other Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morgan City Orthopedic Clinic | Past | Accepting new patients |
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.
-
- Exclusive Provider Organization
- Morgan City, LA
- NPI 1548322365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366505612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2375",
"city": "MORGAN CITY",
"state": "LA",
"postal_code": "70381",
"telephone_number": "985-384-7900",
"fax_number": "985-384-8049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 LAKEWOOD DR SUITE D",
"city": "MORGAN CITY",
"state": "LA",
"postal_code": "70380",
"telephone_number": "985-384-7900",
"fax_number": "985-384-8049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "PHELO",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "OTSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "LA",
"license": "NBCOT981110",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTC NATIONAL",
"identifier": "950290",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBCOT",
"identifier": "981110",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morgan City, LA
- Jeanne Group LLC (Michel's Pharmacy)
- Jeanne Group LLC (Michel's Pharmacy)
- Juan a Escarfuller, M.D., L.L.C.
- Julie E S Price M.D., LLC
- Keith M. Comeaux, O.D. Apoc (St. Mary Eye Care)
- Danette Mary Kelso, MS,RD,LDN
- Kidd and Associcates LLC (Kidd Vision Center)
- Kennedi Kiff, COTA
- Cyrus Kiyanfar, CRNA
- Theresa Nguyet Tien Kober
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.