Active NPI
Keitha Ann Jacellari, APRN, FNP-BC
- Family Nurse Practitioner
- Springfield, MO
National Provider Identifier
1437550167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A004137
- Practice address
- 1335 E Republic Rd
Springfield, MO 65804-7248 - Phone
- (417) 363-3900
- Fax
- (417) 313-9998
- NPI assigned
- Sep 12, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A004137 | AR | Primary |
Addresses
Primary practice location
1335 E Republic Rd
Springfield, MO 65804-7248
Mailing address
PO Box 2452
Mountain View, AR 72560-2452
Phone (870) 615-0825
Other names 1
- Keitha Ann Keech
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14 Medical PLZ
Suite 2
Mountain Home, AR 72653-2919
Phone (870) 232-5315
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A004137 | AR | MD | Family Nurse Practitioner |
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.
-
- Nurse Practitioner
- Mountain Home, AR
- NPI 1437938461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1437550167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2452",
"city": "MOUNTAIN VIEW",
"state": "AR",
"postal_code": "725602452",
"telephone_number": "870-615-0825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 E REPUBLIC RD",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658047248",
"telephone_number": "417-363-3900",
"fax_number": "417-313-9998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACELLARI",
"first_name": "KEITHA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "APRN, FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-12",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A004137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KEITHA",
"last_name": "KEECH",
"middle_name": "ANN",
"credential": "APRN, FNP-BC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.