Chad J Keller, MSED, BSN, RN, ATC

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

13-116483-012 Issued in KS

Practice address

5500 E Kellogg Dr
Wichita, KS 67218-1607

Phone

(316) 685-2221

NPI assigned

Feb 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420243200000",
    "number": "1720052640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 S MICHELLE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672076690",
            "telephone_number": "913-850-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E KELLOGG DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181607",
            "telephone_number": "316-685-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "CHAD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MSED, BSN, RN, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2015-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00315",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "KS",
            "license": "13-116483-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS STATE BOARD OF HEALING ARTS (ATHLETIC TRAINER) AT",
            "identifier": "24-00315",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS STATE BOARD OF NURSING (REGISTERED NURSE)",
            "identifier": "13-116483-012",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Kelderhouse, MA, LPC
• Amy Patricia Keller, DO
• Ashley Lynn Keller, LMSW
• Becky Keller
• Cara Keller, LCPC
• Donna Keller
• Erik Leroy Keller, ATC
• Michael W Keller, LSCSW
• Tara Keller
• Rickey D Kellerman, M.D.

• Ambulatory Care Registered Nurse in Wichita, KS
• Providers in Wichita, KS by specialty
• Ambulatory Care Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; 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.