Roman Keller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904012290 Issued in VA

Practice address

3922 Electric Rd Ste 200
Roanoke, VA 24018-4565

Phone

(540) 776-0716

NPI assigned

Oct 5, 2020

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Brigette Funk LLC

  • Professional Counselor
  • Hardy, VA
  • NPI 1073308250
  Medicare reassignment NPD

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1891392684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 ELECTRIC RD STE 200",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184565",
            "telephone_number": "540-776-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3922 ELECTRIC RD STE 200",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184565",
            "telephone_number": "540-776-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ROMAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Leigh Keith, LCSW
• Tara Keith
• Stephen J Kellam, MD
• Kevin Charles Kelleher, MD
• Jennifer Anne Keller, DPM
• Alison Law Kelley, BEHAVIOR ANALYST
• Josey Kelley
• Michael John Kelley, M.D.
• Vicky Kelley, N.P.
• Kathy Kellogg Bush, LPC

• Clinical Social Worker in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.