NPIMap

Individual provider Active NPI

Jennifer Ellen Keller

  • Pharmacist
  • Gallipolis, OH
National Provider Identifier
1477824654
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03318641 Issued in OH
Practice address
2991 State Route 160
Gallipolis, OH 45631-8441
Phone
(740) 446-6620
Fax
(740) 446-7849
NPI assigned
Jan 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03318641 OH Primary
Pharmacist 183500000X RP0005441 WV

Addresses

Primary practice location

2991 State Route 160
Gallipolis, OH 45631-8441

Mailing address

2991 State Route 160
Gallipolis, OH 45631-8441
Phone (740) 446-6620

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

LicenseStateTypeSpecialty
03318641OHMDPharmacist
RP0005441WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fruth Pharmacy of Ohio Inc Past Accepting new patients
Fruth Pharmacy of Ohio Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1477824654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318441",
            "telephone_number": "740-446-6620",
            "fax_number": "740-446-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318441",
            "telephone_number": "740-446-6620",
            "fax_number": "740-446-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03318641",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "RP0005441",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.