Keith Lincoln Keller, M.D., R.PH.
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Pine Ridge, SD
NPI 1477843282 · NPPES record last updated Apr 26, 2018
Key facts
- NPI
- 1477843282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 145651-1701 (UT)
- Practice address
- IHS Pine Ridge Service Unit
Hwy 18
Pine Ridge, SD 57770 - Phone
- (605) 867-3195
- NPI assigned
- Apr 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10573 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| 11551 | CO | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 145651-1701 | UT | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 16677 | NE | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 11551 | CO | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 10573 | NE | |
| Family Medicine Physician | 207Q00000X | 16677 | NE | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 145651-1701 | UT | Yes |
Addresses
Primary practice location
IHS Pine Ridge Service Unit
Hwy 18
Pine Ridge, SD 57770
Mailing address
PO Box 203
Pine Ridge, SD 57770-0203
Phone (402) 238-4913
Other practice location 1
IHS North 107-202
Pine Ridge, SD 57770
Phone (402) 238-4913
Other providers in Pine Ridge, SD
- Michelle Janis
- Brenda Mae Johnson
- Mary Kathryn Jones
- Peter I Juve
- Christopher Harris Keck
- Debra Lacey
- Tenecia Dawn Lancaster
- Damien Eric Lawhorn
- Wendi S Lewin
- Siyue Li
All providers in Pine Ridge, SD · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.