Individual provider Active NPI

Julie Katherine Keller, MS RD CDE

  • Nutritionist
  • Lapwai, ID
National Provider Identifier
1902816150
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
D-265 Issued in ID
Practice address
111 Bever Grade
Lapwai, ID 83540
Phone
(208) 843-2271
Fax
(208) 843-9406
NPI assigned
Aug 9, 2006
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X D-265 ID Primary

Addresses

Primary practice location

111 Bever Grade
Lapwai, ID 83540

Mailing address

2415 Linda LN
Clarkston, WA 99403-1256
Phone (509) 758-1741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101018000869 TX Practitioner - Registered Dietitian Or Nutrition Professional 1153514534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nez Perce Tribal Health AuthorityGroup PAC ID 0941288302, 16 clinicians

Practice addresses (Care Compare)

111 Bever Grade Rd
Lapwai, ID 83540-0367

PO Box
Suite 367
Lapwai, ID 83540-0367

PO Drawer
Suite 367
Lapwai, ID 83540-0367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County Past Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: juliek@nimiipuuhealth.directbygreenway.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1902816150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 LINDA LN",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031256",
            "telephone_number": "509-758-1741",
            "fax_number": "208-843-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEVER GRADE",
            "city": "LAPWAI",
            "state": "ID",
            "postal_code": "83540",
            "telephone_number": "208-843-2271",
            "fax_number": "208-843-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JULIE",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MS RD CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "ID",
            "license": "D-265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapwai, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.