Individual provider Active NPI

Brian J Keller, RN

  • Registered Nurse
  • Bismarck, ND
National Provider Identifier
1689754780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R26186 Issued in ND
Practice address
4200 E Divide Ave
RJB Armory
Bismarck, ND 58501-7905
Phone
(701) 333-3014
Fax
(701) 333-3016
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R26186 ND Primary

Addresses

Primary practice location

4200 E Divide Ave
RJB Armory
Bismarck, ND 58501-7905

Mailing address

4200 E Divide Ave
RJB Armory
Bismarck, ND 58501-7905
Phone (701) 333-3014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R26186NDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689754780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 E DIVIDE AVE",
            "address_2": "RJB ARMORY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585017905",
            "telephone_number": "701-333-3014",
            "fax_number": "701-333-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E DIVIDE AVE",
            "address_2": "RJB ARMORY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585017905",
            "telephone_number": "701-333-3014",
            "fax_number": "701-333-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "BRIAN",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R26186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.