Dwight S Keller, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

14555 Issued in AZ

Practice address

2940 E Banner Gateway Dr
#200
Gilbert, AZ 85234-2168

Phone

(480) 964-2908

Fax

(480) 833-2136

NPI assigned

Jun 8, 2006

Last updated

Sep 9, 2011By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Mesa Surgical Center, LLC

  dba Paramount Surgery Center of Mesa

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1528284767
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1831130350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29870",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389870",
            "telephone_number": "480-964-2908",
            "fax_number": "480-833-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 E BANNER GATEWAY DR",
            "address_2": "#200",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342168",
            "telephone_number": "480-964-2908",
            "fax_number": "480-833-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "DWIGHT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "14555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z3969",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283333",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle L. Keil
• Lawrence Keister, RN, BSN, MSN, CRNA
• Ilisa J. Keith, MA, LAC
• Lauren Keith, RBT
• Ashley Johnson Keller, PA-C
• Marri Keller, DPT
• Pamela Marie Kelley
• Shannon Kelley, NURSING
• Allison Kellis, RN
• Allysen Kelly, N.P.

• Orthopaedic Surgery Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.