Active NPI
Keli Nicole Keener, MSED, ATC, LAT
- Athletic Trainer
- Belleville, IL
National Provider Identifier
1922594142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.002057
- Practice address
- 4600 Memorial Dr
Belleville, IL 62226-5368 - Phone
- (618) 257-5250
- NPI assigned
- Jul 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.002057 | IL | Primary |
Addresses
Primary practice location
4600 Memorial Dr
Belleville, IL 62226-5368
Mailing address
4063 Frank Scott Pkwy W
Belleville, IL 62223-6802
Phone (618) 222-7635
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.002057 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551398400000",
"number": "1922594142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4063 FRANK SCOTT PKWY W",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622236802",
"telephone_number": "618-222-7635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 MEMORIAL DR",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265368",
"telephone_number": "618-257-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENER",
"first_name": "KELI",
"middle_name": "NICOLE",
"credential": "MSED, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-11",
"last_updated": "2019-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.002057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.