Jennifer L Keller, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2010004829 Issued in MO

Practice address

300 SE 2ND St
Lees Summit, MO 64063-2759

Phone

(816) 404-6106

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Truman Medical Center, Incorporated

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1144207937
  Medicare reassignment NPD
• Truman Medical Center Incorporated

  • Community/Behavioral Health Agency
  • Kansas City, MO
  • NPI 1497890495
  NPD
• Truman Medical Center, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kansas City, MO
  • NPI 1225773401
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1649331067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SE 2ND ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632759",
            "telephone_number": "816-404-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SE 2ND ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632759",
            "telephone_number": "816-404-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2010004829",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2817",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Edward Kearns, PA-C
• Katherine Anne Keaton, APRN
• Chandler Keeton
• Melissa Kehoe
• Kali Keilbey, LPC
• Norma Jean Kelley, LCSW
• Taylor Lynn Kelley
• Destiny Janae Kelly, COTA/L
• Kay Kelly
• Misty Kelso

• Clinical Psychologist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.