Shannon A Keller

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

4823 N Royal Atlanta Dr
Suite C
Tucker, GA 30084-3806

Phone

(770) 939-2121

NPI assigned

Apr 26, 2007

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: georgiabehavioralhealthprofessionals.shannonkeller@124220.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Recovery Network LLC

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952521650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 DELTA CORS",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300455407",
            "telephone_number": "770-982-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4823 N ROYAL ATLANTA DR",
            "address_2": "SUITE C",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843806",
            "telephone_number": "770-939-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "SHANNON",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saba Karamali
• Danielle Alyssa Kardon, MOT, OTR/L
• Glenn Kasow, DO
• Berhanu Ejigu Kededa, NP-C
• Keeping U Gorgeous Extensions &Wigs LLC
• Kelly Keyser, LLC
• Caleb Elijah Keran, DC
• Jane M Kerner-Mendoza, CNS
• Kelly Keyser, LPC
• Sohaib A. Khalid, MD

• Professional Counselor in Tucker, GA
• Providers in Tucker, GA by specialty
• Professional Counselor in Georgia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.