Individual provider Active NPI

Andrew Lester Keller, NP

  • Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1508154915
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15824 Issued in TN
Practice address
110 N Campbell Station Rd
Knoxville, TN 37934
Phone
(865) 672-5070
Fax
(865) 671-6680
NPI assigned
Jul 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15824 TN Primary

Addresses

Primary practice location

110 N Campbell Station Rd
Knoxville, TN 37934

Mailing address

PO Box 660257
Birmingham, AL 35266-0257
Phone (205) 979-5882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121121000341 TN Practitioner - Nurse Practitioner 7113178153 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15824TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Medicine of the South, PLLC Current Accepting new patients
Total Healthcare Consultants PC Current Accepting new patients
Pain Medicine of the South, PLLC CurrentSince Dec 26, 2017 Accepting new patients
Dowell Springs Behavioral Health, LLC CurrentSince Jun 15, 2022 Accepting new patients

Locations

1444 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 500-6665

110 N Campbell Station Rd
Knoxville, TN 37934
Phone (865) 672-5070

200 New York Ave
Ste 320
Oak Ridge, TN 37830
Phone (334) 482-9633

Organizations & group practices 4

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1508154915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660257",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352660257",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N CAMPBELL STATION RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37934",
            "telephone_number": "865-672-5070",
            "fax_number": "865-671-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ANDREW",
        "middle_name": "LESTER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "15824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.