Active NPI
Nathaniel Keller
- Clinical Social Worker
- Worthington, OH
National Provider Identifier
1407306616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S.1903460
- Practice address
- 445 E Dublin Granville Rd
Worthington, OH 43085 - Phone
- (614) 436-7837
- NPI assigned
- Oct 12, 2016
- Last updated
- Jun 19, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S.1903460 | OH | Primary |
Addresses
Primary practice location
445 E Dublin Granville Rd
Worthington, OH 43085
Mailing address
445 E Dublin Granville Rd
Worthington, OH 43085-3192
Other practice location 1
445 E Dublin Granville Rd
Worthington, OH 43085
Phone (614) 436-7837 ext. 2282
Other practice location 2
110 Roach St
Georgetown, KY 40324-9393
Phone (502) 863-4734
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790731081 | Medicaid | KY |
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 |
|---|---|---|---|
| S.1903460 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lexington Counseling and Psychiatry, PLLC | Clinical | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Lexington, KY
- NPI 1881789634
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592524800000",
"number": "1407306616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 E DUBLIN GRANVILLE RD",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430853192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 E DUBLIN GRANVILLE RD",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "43085",
"telephone_number": "614-436-7837"
}
],
"practiceLocations": [
{
"address_1": "445 E Dublin Granville Rd",
"address_purpose": "LOCATION",
"city": "Worthington",
"state": "OH",
"postal_code": "43085",
"country_code": "US",
"telephone_number": "614-436-7837 x2282",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "110 Roach St",
"address_purpose": "LOCATION",
"city": "Georgetown",
"state": "KY",
"postal_code": "403249393",
"country_code": "US",
"telephone_number": "502-863-4734",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLER",
"first_name": "NATHANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-12",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S.1903460",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1790731081",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.