Mark Keller, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01104200 Issued in NJ

Practice address

122 Brandon Rd
Pennington, NJ 08534-1931

Phone

(908) 642-5083

NPI assigned

Jan 9, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1641686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1922769173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BUNN DR",
            "address_2": "STE 102",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401968",
            "telephone_number": "908-642-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 BRANDON RD",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341931",
            "telephone_number": "908-642-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "MARK",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-09",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01104200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pennington",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "122 Brandon Rd",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085341931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Kausch, APN
• Melanie Kara Kavitsky, CRNA
• Adam Kazimierczak, DO
• Christopher Joseph Kazior, DMD
• Dana Christine Keddie, PA-C
• Megan Kelley, LPC
• Nicholas Kelley, DMD, MSD
• Laura Kelly, PSY.D.
• Mateen A Khan, MD
• Nadiya Khan

• Physical Therapist in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.