Individual provider Active NPI

Bailey Joel Keller, PA-C

  • Physician Assistant
  • Quincy, IL
National Provider Identifier
1609755057
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085011694 Issued in IL
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(217) 223-1200
Fax
(217) 223-6894
NPI assigned
Aug 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085011694 IL Primary

Addresses

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

900 N 27TH St
Quincy, IL 62301-3564
Phone (217) 779-7053

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107000055 IL Practitioner - Physician Assistant 9638669674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085011694ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital Current Accepting new patients
Blessing Hospital CurrentSince Nov 1, 2025 Accepting new patients
Blessing Hospital CurrentSince Nov 1, 2025 Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1609755057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N 27TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013564",
            "telephone_number": "217-779-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-1200",
            "fax_number": "217-223-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BAILEY",
        "middle_name": "JOEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.