NPIMap

Individual provider Active NPI

Kevin R. Keller, MD

  • Allergy & Immunology Physician
  • Marshfield, WI
National Provider Identifier
1790720795
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
66691 Issued in WI
Practice address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone
(715) 387-5186
NPI assigned
Jun 17, 2006
Last updated
May 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X C-8356 AR
Allergy & Immunology Physician 207K00000X 66691 WI Primary

Addresses

Primary practice location

1000 N Oak Ave
Marshfield, WI 54449-5703

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5186

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20170206002473 WI Practitioner - Allergy/Immunology 6709855000 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Texas Medical Branch at Galveston, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

2310 Craig Rd
Eau Claire, WI 54701-6128
Phone (715) 858-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66691WIMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jun 5, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jun 5, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Marshfield Clinic Inc CurrentSince Mar 6, 2017 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: kevin.keller@marshfieldclinichealthsystem.cernerdirect.com

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 6

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1790720795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KEVIN",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "AR",
            "license": "C-8356",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WI",
            "license": "66691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.