Individual provider Active NPI

John Jeffrey Keller, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Chillicothe, OH
National Provider Identifier
1700849114
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
35076888 Issued in OH
Practice address
4437 State Route 159
Suite 125
Chillicothe, OH 45601-7065
Phone
(740) 779-4570
Fax
(740) 779-4579
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 35076888 OH Primary

Addresses

Primary practice location

4437 State Route 159
Suite 125
Chillicothe, OH 45601-7065

Mailing address

4437 State Route 159 Ste 125
Chillicothe, OH 45601-7065
Phone (740) 779-4570

Other identifiers 5

IdentifierTypeStateIssuer
2592001MedicaidOH
P00236852OtherRAILROAD MEDICARE
130671OtherNATIONWIDE
2504684OtherUNITED HEALTHCARE
000000000362661OtherANTHEM BCBS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adena.cardio@adena.medicity.net
Direct Messaging Address jkeller37810@lickingmemorial.medicity.net Licking Memorial Health Professionals

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20050608000845 OH Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1951344159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Cincinnati College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Licking Memorial Health ProfessionalsGroup PAC ID 6204740731, 235 clinicians

Practice addresses (Care Compare)

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4137

Hospital & facility affiliations

  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35076888OHMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corporation CurrentSince Aug 7, 2024 Accepting new patients
Adena Medical Group LLC CurrentSince Jul 12, 2013 Accepting new patients
Licking Memorial Hospital Current Accepting new patients
Licking Memorial Health Professionals CurrentSince Aug 7, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1906 Tamarack Rd
Newark, OH 43055
Phone (220) 564-7780

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: jkeller@lickingmemorial.medicity.net

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 6

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1700849114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 STATE ROUTE 159 STE 125",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456017065",
            "telephone_number": "740-779-4570",
            "fax_number": "740-779-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4437 STATE ROUTE 159",
            "address_2": "SUITE 125",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456017065",
            "telephone_number": "740-779-4570",
            "fax_number": "740-779-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JOHN",
        "middle_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "OH",
            "license": "35076888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2592001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00236852",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE",
            "identifier": "130671",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2504684",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000000362661",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.cardio@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4437 State Route 159",
            "address_2": "Suite 125",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456017065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkeller37810@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Health Professionals",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.