NPIMap

Individual provider Active NPI

John F. Keller, M.D.

  • Neurological Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1770664583
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
054648 Issued in MI
Practice address
3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570
Phone
(616) 454-3465
Fax
(616) 454-9004
NPI assigned
Oct 18, 2006
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 054648 MI Primary

Addresses

Primary practice location

3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570

Mailing address

3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570
Phone (616) 454-3465

Other identifiers 1

IdentifierTypeStateIssuer
4111797MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060309000338 MI Practitioner - Neurosurgery 1759287048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Michigan State University College of Human Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Neurosurgical Associates PCGroup PAC ID 5890691182, 13 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

3350 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-4570
Phone (616) 454-3465

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion145
Laminectomy or laminotomy (partial removal of spine bones)53

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054648MIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Neurosurgical Associates, PC CurrentSince Mar 11, 2025 Accepting new patients
Great Lakes Neurosurgical Associates, PC Neurological Surgery CurrentSince Sep 1, 1999 Accepting new patients
Sheridan Community Hospital CurrentSince May 1, 2024 Accepting new patients
Sheridan Community Hospital CurrentSince May 1, 2024 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

3350 Eagle Park Dr NE
Ste 102
Grand Rapids, MI 49525
Phone (616) 242-7042

414 Plymouth Ave NE
Grand Rapids, MI 49505
Phone (616) 454-3465

301 N Main St
Sheridan, MI 48884
Phone (989) 291-3261

Interoperability endpoints

  • Direct secure messaging: jkeller1147@direct.metrohealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1770664583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 EAGLE PARK DR NE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254570",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 EAGLE PARK DR NE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254570",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JOHN",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "054648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111797",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.