Individual provider Active NPI

David Keller, B.I.S., D.C.

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1790405868
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-2297 Issued in ID
Practice address
5956 N. Linder Rd.
Suite 120
Meridian, ID 83646
Phone
(815) 977-1931
NPI assigned
Aug 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-2297 ID Primary

Addresses

Primary practice location

5956 N. Linder Rd.
Suite 120
Meridian, ID 83646

Mailing address

5956 N. Linder Rd.
Suite 120
Meridian, ID 83646
Phone (815) 977-1931

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230511002818 ID Practitioner - Chiropractic 6204292543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5956 N Linder Rd
Suite 120
Meridian, ID 83646-5108
Phone (806) 549-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-2297IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
100 Chiro Keller, PLLC. Chiropractor CurrentSince Apr 17, 2023 Accepting new patients

Locations

5956 N Linder Rd
Ste 120
Meridian, ID 83646
Phone (815) 977-1931

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1790405868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5956 N. LINDER RD.",
            "address_2": "SUITE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "815-977-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5956 N. LINDER RD.",
            "address_2": "SUITE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "815-977-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "B.I.S., D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.