Jonathan Richard Keller, CADAC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CI05830516 Issued in CA

Practice address

330 E Roosevelt St Apt 5008
Phoenix, AZ 85004-4313

Phone

(619) 733-0906

NPI assigned

May 19, 2016

Last updated

Dec 20, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13108/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Tiger Recovery Inc

  • Clinical Social Worker
  • Palm Desert, CA
  • NPI 1508276056
  NPD (past)

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1649627514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E ROOSEVELT ST APT 5008",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044313",
            "telephone_number": "619-733-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E ROOSEVELT ST APT 5008",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044313",
            "telephone_number": "619-733-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "credential": "CADAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "CI05830516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alixandria Christine Keller
• Casey Keller
• Colleen Keller, FNP, RN
• Ian Keller
• Jessica Keller, DNP, FNP-BC, NP-C
• Kathryn Keller
• Linda Keller
• Lisa Ann Keller, P.N.P.
• Lori Sue Keller, FNP
• Martin E Keller, EDD ABPP

• Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.