Individual provider Active NPI

Patricia A Keeler

  • Behavior Analyst
  • Gladstone, OR
National Provider Identifier
1912383506
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
880 SE 82ND Drive
Gladstone, OR 97027
Phone
(503) 659-5515
NPI assigned
Aug 5, 2015
Last updated
Aug 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

880 SE 82ND Drive
Gladstone, OR 97027

Mailing address

880 SE 82ND Drive
Gladstone, OR 97027
Phone (503) 659-5515

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1912383506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 SE 82ND DRIVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "97027",
            "telephone_number": "503-659-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SE 82ND DRIVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "97027",
            "telephone_number": "503-659-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELER",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.