Glen E Keller, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3369 Issued in OH

Practice address

10400 Lancaster Newark Rd NE
Millersport, OH 43046-8003

Phone

(740) 467-2486

Fax

(740) 467-2498

NPI assigned

Jan 17, 2006

Last updated

Apr 8, 2008By the provider in NPPES

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 6

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Keller Family Chiropractic, LLC

  • Chiropractor
  • Millersport, OH
  • NPI 1184781171
  Medicare reassignment NPD Authorized official
• Pickerington Chiropractic Center

  • Chiropractor
  • Pickerington, OH
  • NPI 1134318033
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1730169897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 LANCASTER NEWARK RD NE",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430468003",
            "telephone_number": "740-467-2486",
            "fax_number": "740-467-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 LANCASTER NEWARK RD NE",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430468003",
            "telephone_number": "740-467-2486",
            "fax_number": "740-467-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "GLEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3369",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA 576",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000509974",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECIALTY HEALTH",
            "identifier": "1003201",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2474059",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN CHIRO NTWRK(ACN)",
            "identifier": "665855",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11176716",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5585251",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra N Grant, LMT
• Haga Corporation (Millersport Pharmacy)
• Holly Brianne Hite
• Keller Family Chiropractic, LLC
• Anton Leroy Keller, D.C.
• Michael James Martin Jr., MD.
• Nicole Renee Miller, LPN
• Evan Myers
• Jane H Perkins, OTR/L
• Wendy Jo Rinehart

• Chiropractor in Millersport, OH
• Providers in Millersport, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.