Beatrice Keller Clinic, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BEATRICE KELLER CLINIC, PC

Practice address

13943 N 91St Ave
C-101
Peoria, AZ 85381-3687

Phone

(623) 972-3992

Fax

(623) 974-9351

NPI assigned

May 12, 2006

Last updated

Jun 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James W Groff, D.O.NPI 1265480644

Title

President

Phone

(623) 584-2127

Specialties & licenses 1

Addresses

Other identifiers 8

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926

  Member Of

  NPD member

Locations

Practitioners 3

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.

• James W Groff, DO

  • Dermatology Physician
  • Sun City West, AZ
  • NPI 1265480644
  Authorized official Same address or phone
• Samuel Devictor, MD

  • Facial Plastic Surgery Physician
  • Scottsdale, AZ
  • NPI 1619301884
  NPD (past)
• Emily Jenson, P.A.-C

  • Medical Physician Assistant
  • Scottsdale, AZ
  • NPI 1932641594
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1467402933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE",
            "address_2": "C-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813687",
            "telephone_number": "623-972-3992",
            "fax_number": "623-974-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE",
            "address_2": "C-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813687",
            "telephone_number": "623-972-3992",
            "fax_number": "623-974-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEATRICE KELLER CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-584-2127",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4265098",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "838542",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0846027",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CT0844",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "000838542",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "1467402933",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORK COMP",
            "identifier": "188961600",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0813027",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark A Bean, PSY.S
• Oleah Bean
• Alicia Joy Beanblossom, L.M.T.
• Leonard Eugene Beare, D.D.S.
• Abigail Beasley
• Ashleigh Beatty
• Brooke Michelle Beauchamp
• Michal Bechtold, RN
• Kenneth Becker, FNP-BC
• Angela Jill Beckett, LPN

• Dermatology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.