John Robert J Keller, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

019029394 Issued in IL

Practice address

4113 Humbert Rd
Alton, IL 62002-7116

Phone

(618) 465-7777

NPI assigned

Jun 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carrow and Chapel Dentistry Partnership

  • General Practice Dentistry
  • Alton, IL
  • NPI 1649288069
  NPD (past)

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1528406089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 HUMBERT RD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027116",
            "telephone_number": "618-465-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 HUMBERT RD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027116",
            "telephone_number": "618-465-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JOHN ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Kapp, BS
• Ahmad A Karadaghy, M.D.
• Laura L Kaupas, MSW, LCSW, CADC/MISA
• Haley Marie Kearby, PTA
• Sandra Kearns, BS
• Christa D Kelly, PT
• Molly Marie Kemner, MAT, ATC
• Sohaib Muhammad Khan, MD
• Nazanin Kheirkhahan, MD
• James H Kiehne, DDS

• Dentist in Alton, IL
• Providers in Alton, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.