Active NPI
John L Keller, D.C.
- Chiropractor
- Springdale, AR
National Provider Identifier
1770549065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 914
- Practice address
- 2988 W Huntsville Ave
Ste. C
Springdale, AR 72762-7726 - Phone
- (479) 756-6991
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 914 | AR | Primary |
Addresses
Primary practice location
2988 W Huntsville Ave
Ste. C
Springdale, AR 72762-7726
Mailing address
2988 W Huntsville Ave
Ste. C
Springdale, AR 72762-7726
Phone (479) 756-6991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050428000405 | AR | Practitioner - Chiropractic | 2163461286 | Practice locations: Springdale, AR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 914 | AR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298246400000",
"number": "1770549065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2988 W HUNTSVILLE AVE",
"address_2": "STE. C",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727627726",
"telephone_number": "479-756-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2988 W HUNTSVILLE AVE",
"address_2": "STE. C",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727627726",
"telephone_number": "479-756-6991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "JOHN",
"middle_name": "L",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2011-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.