Amy M. Keller OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

AK003308 Issued in MI

Legal business name

AMY M. KELLER OD PC

Practice address

115 W Upton Avenue
Reed City, MI 49677-1129

Phone

(231) 832-3133

Fax

(231) 832-1417

NPI assigned

Mar 20, 2007

Last updated

Jun 29, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

AMY M. KELLER OD PCAs reported in NPPES

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

Authorized official

Name

Dr. Amy M Keller, ODNPI 1336259761

Title

President

Phone

(231) 832-3133

Specialties & licenses 1

Addresses

Other identifiers 5

Part of

Amy M Keller OD PC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Marie Keller, O.D.

  • Optometrist
  • Reed City, MI
  • NPI 1336259761
  Authorized official Same address or phone

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372464000000",
    "number": "1578688552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W UPTON AVENUE",
            "city": "REED CITY",
            "state": "MI",
            "postal_code": "496771129",
            "telephone_number": "231-832-3133",
            "fax_number": "231-832-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W UPTON AVENUE",
            "city": "REED CITY",
            "state": "MI",
            "postal_code": "496771129",
            "telephone_number": "231-832-3133",
            "fax_number": "231-832-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY M. KELLER OD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMY M. KELLER OD PC",
        "enumeration_date": "2007-03-20",
        "last_updated": "2013-06-29",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-832-3133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "AK003308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2883730",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR FEDERAL, INC",
            "identifier": "0289080001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. WILSON'S PERSONAL NPI",
            "identifier": "1184727612",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. KELLER'S PERSONAL NPI",
            "identifier": "1336259761",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "0N43890",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Reed City, MI
• Providers in Reed City, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2013; 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.