Individual provider Active NPI

Laura Keller, NP

  • Nurse Practitioner
  • Weaverville, CA
National Provider Identifier
1376563007
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8729 Issued in CA
Practice address
560 Main Street
Weaverville, CA 96093
Phone
(530) 623-3735
Fax
(530) 623-1196
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8729 CA Primary

Addresses

Primary practice location

560 Main Street
Weaverville, CA 96093

Mailing address

PO Box 2460
560 Main Street
Weaverville, CA 96093-2460
Phone (530) 623-3735

Other identifiers 1

IdentifierTypeStateIssuer
RN476117MedicaidCA

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Donald E. Krouse, M.D., Inc PastSince Apr 17, 2006 Accepting new patients
Donald E. Krouse, M.D. Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1376563007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2460",
            "address_2": "560 MAIN STREET",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "960932460",
            "telephone_number": "530-623-3735",
            "fax_number": "530-623-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 MAIN STREET",
            "city": "WEAVERVILLE",
            "state": "CA",
            "postal_code": "96093",
            "telephone_number": "530-623-3735",
            "fax_number": "530-623-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "LAURA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "8729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN476117",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weaverville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.