Gary John Keller, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

3844 Issued in IA

Practice address

2700 Coral Ridge Ave
Coralville, IA 52241-4708

Phone

(319) 626-4279

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Iowa Medical & Classification Center

  • Prison Health Clinic/Center
  • Coralville, IA
  • NPI 1326448846
  NPD (past)
• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1821170473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 CORAL RIDGE AVE",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522414708",
            "telephone_number": "319-626-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CORAL RIDGE AVE",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522414708",
            "telephone_number": "319-626-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "3844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Solveig Kase, MA, LMHC, LPC
• Katie Amos LMFT, RPT, LLC
• Kathryn Patricia Kaufman, PA-C
• James R Kay, PHARMD
• Andrew John Keinroth, D.C.
• Kelly Chiropractic, PLLC
• Erin Margaret Kelly, MA
• Grace Ann Kelly, D.C.
• Griffin Kelly
• Nathan Peter Kepros

• Psychiatry Physician in Coralville, IA
• Providers in Coralville, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.