Pamela E Keller, MD
Individual provider Active NPI Family Medicine Physician · Forest City, IA
NPI 1497862072 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497862072
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 29418 (IA)
- Practice address
- 635 E US Hwy
Forest City, IA 50436-0000 - Phone
- (641) 585-2904
- Fax
- (641) 585-5417
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091109000632 | IA | Practitioner - Family Practice | 1254335755 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29418 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Iowa Mercy Clinics | Current | Accepting new patients | |
| North Iowa Mercy Clinics | Family Medicine | Current |
Accepting new patients |
| North Iowa Mercy Clinics | Current |
Accepting new patients | |
| Floyd County Memorial Hospital Commission | Family Medicine | Past | Accepting new patients |
Locations
505 S 1st Ave E
Lake Mills, IA 50450
Phone (641) 592-3900
621 S Illinois Ave
Ste 103
Mason City, IA 50401
1000 4th St SW
Mason City, IA 50401
Phone (641) 424-6704
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 29418 | IA | Yes |
Addresses
Primary practice location
635 E US Hwy
Forest City, IA 50436-0000
Mailing address
621 S Illinois Ave
Suite 103
Mason City, IA 50401-5489
Phone (641) 494-3041
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19507 | Other | IA | WELLMARK |
| 2099119 | Medicaid | IA |
Other providers in Forest City, IA
- Rebekah G. Hennigar
- Hy-Vee Inc
- J&J Pharmacy Inc
- Trichelle Mae Jackson
- Taylor Paige Julius
- Jack Koenen
- Joeli Emma Koenig
- James E McGuire
- Carla McWilliams
- Jason J Miller
All providers in Forest City, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.