NPIMap

Organization Active NPI

Rodney C. Keller PC

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1912173063
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00472 Issued in TX
Legal business name
RODNEY C. KELLER PC
Practice address
319 E Mulberry Ave
San Antonio, TX 78212-3024
Phone
(210) 415-4278
Fax
(210) 757-4030
NPI assigned
May 7, 2008
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
RODNEY C. KELLER, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Mr. Rodney Carlyle Keller Sr., LCSW, LMFT
Title
President
Phone
(210) 415-4278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 00472 TX Primary

Addresses

Primary practice location

319 E Mulberry Ave
San Antonio, TX 78212-3024

Mailing address

1502 Beauchamp St
San Antonio, TX 78213-1210
Phone (210) 415-4278

Other identifiers 2

IdentifierTypeStateIssuer
064191201MedicaidTX
1679654545OtherTXNPI

National Provider Directory

National Provider Directory
Part of
Rodney C Keller PC

Locations

319 E Mulberry Ave
San Antonio, TX 78212
Phone (210) 415-4278

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1912173063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 BEAUCHAMP ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131210",
            "telephone_number": "210-415-4278",
            "fax_number": "210-757-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E MULBERRY AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782123024",
            "telephone_number": "210-415-4278",
            "fax_number": "210-757-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODNEY C. KELLER PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RODNEY C. KELLER, PC",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "CARLYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-415-4278",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LCSW, LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "00472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064191201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679654545",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.