Lisa Jean Keller, R.D., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD377 Issued in OK

Practice address

6160 S Yale Ave
Tulsa, OK 74136-1930

Phone

(918) 497-3041

Fax

(918) 499-3295

NPI assigned

Nov 2, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sunshine Community Services of Tulsa Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Tulsa, OK
  • NPI 1356176150
  Medicare reassignment NPD
• Mobile Medical Consultants, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1346839859
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1831278746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361930",
            "telephone_number": "918-497-3041",
            "fax_number": "918-499-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "LISA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "LD377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200434810A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Marvin Keller, M.D.
• Jarret Dwight Keller, PA-C
• Jessica Keller, MD
• John Keller, DPT
• Kaye A Keller
• Madalene Keller
• Scott A Keller, MD
• Stephanie Keller
• Ammie Wall Kelley
• Ashley Marie Kelley, LCSW

• Registered Dietitian in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.