NPIMap

Organization Active NPI

Keller Family Medical Center, PLLC

  • Family Medicine Physician
  • Keller, TX
National Provider Identifier
1407489347
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KELLER FAMILY MEDICAL CENTER, PLLC
Practice address
808 Keller Pkwy
Keller, TX 76248-2405
Phone
(817) 431-2573
Fax
(817) 379-6881
NPI assigned
Feb 19, 2020
Last updated
Dec 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Dr. Christopher D Dingess, DONPI 1982016192
Title
Physician/Owner
Phone
(817) 431-2573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

808 Keller Pkwy
Keller, TX 76248-2405

Mailing address

808 Keller Pkwy
Keller, TX 76248-2405
Phone (817) 431-2573

Other practice location 1

312 E Renfro St Ste 101
Burleson, TX 76028-3948
Phone (817) 710-8800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KGILL@KELLERFAMILYMEDICAL.COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201209001973 TX Part B Supplier - Clinic/Group Practice 9335551795 Receives reassigned benefits from 7 practitioners
Practice locations: Burleson, TX; Keller, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0703778Keller Family Medical Center808 Keller Parkway, Keller, TX 76248Certificate of waiverApr 13, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28296/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kgill@kellerfamilymedical.com

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1407489347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573",
            "fax_number": "817-379-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573",
            "fax_number": "817-379-6881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 E Renfro St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Burleson",
            "state": "TX",
            "postal_code": "760283948",
            "country_code": "US",
            "telephone_number": "817-710-8800",
            "fax_number": "817-379-6881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLER FAMILY MEDICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "DINGESS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "817-431-2573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KGILL@KELLERFAMILYMEDICAL.COM",
            "affiliation": "N",
            "address_1": "808 Keller Pkwy",
            "city": "Keller",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762482405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.