Justin D Keller, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1739 Issued in ID

Practice address

3510 12TH St
200
Lewiston, ID 83501-5575

Phone

(208) 799-3333

Fax

(208) 799-3375

NPI assigned

Jul 11, 2016

Last updated

Sep 28, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

ChiropracticAlso: Sports Medicine

Education

Western States College of Chiropractic, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kurt A Bailey, DC, NP-C

  • Chiropractor
  • Lewiston, ID
  • NPI 1528046661
  Medicare reassignment

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1659723989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18919 DOUBLE T LN",
            "city": "LENORE",
            "state": "ID",
            "postal_code": "835416088",
            "telephone_number": "208-816-3365",
            "fax_number": "208-799-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 12TH ST",
            "address_2": "200",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015575",
            "telephone_number": "208-799-3333",
            "fax_number": "208-799-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1739",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "CHIN-1718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K'Lee Lynae Kasper, BSN, RN, IBCLC
• Tara Kazemfar, PT
• Mark R Keane, M.D.
• Leroy Neal Keene, PAC
• Lauren Keeney
• Kelley Kids Ranch, LLC
• Jordan Kelley, LMSW
• David Kendrick, M.D.
• Kent B. Simmons DDS, PLLC
• Lindsay R Kern, MD

• Chiropractor in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.