Charles Robert Keller, D.O.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

34003787 Issued in OH

Practice address

1383 W Hunter St
Logan, OH 43138-1013

Phone

(740) 385-0202

Fax

(740) 380-2734

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: ckeller608365@direct.osumc.edu

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1629189311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431380228",
            "telephone_number": "740-385-0202",
            "fax_number": "740-380-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 W HUNTER ST",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431381013",
            "telephone_number": "740-385-0202",
            "fax_number": "740-380-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "34003787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0565240",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckeller608365@direct.osumc.edu",
            "affiliation": "N",
            "endpointDescription": "Hocking Valley Community Hospital Rural Health Clinic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1383 W Hunter St",
            "city": "Logan",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431381013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diane Lynn Kaufman
• Bashar F Kayali, M.D.
• Aveline A Keck, LPN
• Keith a. Taulbee, D.C., Inc.
• Colleen Marie Kelleher, P.T.
• Hope E. Kelly, APRN-CNP
• Debbie Kennard
• Stormie Dawn Kettlewell, R.N.
• Denise Kiamy, RDN, LD
• Candice Kilbarger, APRN

• Adult Medicine Physician in Logan, OH
• Providers in Logan, OH by specialty
• Adult Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.