Stephannie L Keller

Primary specialty

Optometric TechnicianTaxonomy code 156FX1202X

Practice address

Double Imange, Inc. Dba Pearle Vision
3001 White Bear Ave., No., Suite 1050
St Paul, MN 55109

Phone

(651) 770-3923

Fax

(952) 435-2624

NPI assigned

Oct 3, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902991466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DOUBLE IMANGE, INC. DBA PEARLE VISION",
            "address_2": "3001 WHITE BEAR AVE., NO., SUITE 1050",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-770-3923",
            "fax_number": "952-435-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DOUBLE IMANGE, INC. DBA PEARLE VISION",
            "address_2": "3001 WHITE BEAR AVE., NO., SUITE 1050",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-770-3923",
            "fax_number": "952-435-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "STEPHANNIE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1202X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optometric Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Mae Kellen George, RDH
• Charles Anthony Keller, D.D.S.
• Curtis D Keller, MD
• Kyle Keller
• Nicholas Keller, LICSW
• Britni Kelley, MA
• Joan Kelley
• Marianne P Kelley, PSYD LP
• Margaret B Kellogg, M.A., L.P.
• Amy Marie Kelly, M.D.

• Technician/Technologist in St Paul, MN
• Providers in St Paul, MN by specialty
• Technician/Technologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.