Individual provider Active NPI

Kurt William Keller, MD

  • Emergency Medicine Physician
  • Monroe, LA
National Provider Identifier
1689170425
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
319985 Issued in LA
Practice address
4864 Jackson St
Monroe, LA 71202-6400
Phone
(318) 330-7000
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 319985 LA Primary
Emergency Medicine Physician 207P00000X S9006 TX
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4864 Jackson St
Monroe, LA 71202-6400

Mailing address

1512 W Kirby PL
Shreveport, LA 71103-3822
Phone (318) 626-0287

Other practice location 1

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210823001424 LA Practitioner - Emergency Medicine 8921347543 Reassigns benefits to 1 organization
I20220328001061 TX Practitioner - Emergency Medicine 8921347543 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical School at San Antonio, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Practice addresses (Care Compare)

6800 Scenic Dr
Rowlett, TX 75088-4552
Phone (972) 412-3345

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Ies Central Texas PLLC Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
Legacy Urgent Care, PA CurrentSince Mar 16, 2024 Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Frisco Emergency Medicine Associates, PA Emergency Medicine Past Accepting new patients

Locations

4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1310 W Exchange Pkwy
Ste 100
Allen, TX 75013
Phone (972) 678-4545

330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777

3500 Gaston Ave
Dallas, TX 75246

7 Medical Pkwy
Farmers Brnch, TX 75234
Phone (972) 247-1000

9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

5501 S Expressway 77
Harlingen, TX 78550
Phone (936) 569-9481

101 Circle Dr
Hillsboro, TX 76645
Phone (254) 580-8500

2600 W Pleasant Run Rd
Lancaster, TX 75146
Phone (469) 297-5321

2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277

1011 N Galloway Ave
Mesquite, TX 75149
Phone (214) 320-7000

8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

211 W Frontier Pkwy
Prosper, TX 75078
Phone (469) 868-9100

6800 Scenic Dr
Rowlett, TX 75088
Phone (972) 412-2273

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2300 W FM 544
Ste 100
Wylie, TX 75098
Phone (469) 366-3400

Organizations & group practices 6

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 1

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1689170425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KURT",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "319985",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S9006",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.