Individual provider Active NPI

Scott Keller, DC

  • Chiropractor
  • Ronkonkoma, NY
National Provider Identifier
1508893785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X007598 Issued in NY
Practice address
2805 Veterans Memorial Hwy
Suite #8
Ronkonkoma, NY 11779-7647
Phone
(631) 738-8300
Fax
(631) 738-8500
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X007598 NY Primary

Addresses

Primary practice location

2805 Veterans Memorial Hwy
Suite #8
Ronkonkoma, NY 11779-7647

Mailing address

2805 Veterans Memorial Hwy
Suite #8
Ronkonkoma, NY 11779-7647
Phone (631) 738-8300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
X007598NYMDChiropractor
007598NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508893785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 VETERANS MEMORIAL HWY",
            "address_2": "SUITE #8",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797647",
            "telephone_number": "631-738-8300",
            "fax_number": "631-738-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 VETERANS MEMORIAL HWY",
            "address_2": "SUITE #8",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797647",
            "telephone_number": "631-738-8300",
            "fax_number": "631-738-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X007598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.