David D Keller DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DAVID D KELLER DO PC

Practice address

195 Fore River Pkwy Ste 470
Portland, ME 04102-2787

Phone

(207) 347-3164

Fax

(207) 899-3195

NPI assigned

Dec 11, 2018

Organization subpart

No

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

Authorized official

Name

David D Keller, DONPI 1861448201

Title

Owner

Phone

(207) 347-3164

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David D Keller, D.O

  • Family Medicine Physician
  • Portland, ME
  • NPI 1861448201
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1417428848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY STE 470",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022787",
            "telephone_number": "207-347-3164",
            "fax_number": "207-899-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY STE 470",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022787",
            "telephone_number": "207-347-3164",
            "fax_number": "207-899-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID D KELLER DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-347-3164",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Dattilo, PHD
• Kellsey Rae Davenport, PT, DPT
• Pamela R Davenport, SOCIAL WORKER
• Kathleen Mara Davey, M.D.
• David a Vaughan DDS PA
• David Lobozzo, MD, PA
• David Margolis PH.D. P.a.
• David R Kerr
• David Thomson MD Facs
• Deborah Leah Davidson, M.SC, CCC-SLP

• Family Medicine Physician in Portland, ME
• Providers in Portland, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.