Jennifer Keeler, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Sullivan, MO
NPI 1962027235 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1962027235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2020016174 (MO)
- Practice address
- 101 Progress Pkwy
Sullivan, MO 63080-2359 - Phone
- (888) 403-1071
- NPI assigned
- Jun 12, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Compass Health Inc
Practice addresses (Care Compare)
1780 Old Hwy 50 E
Suite 102
Union, MO 63084-3397
Phone (888) 403-1071
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200616002639 | MO | Practitioner - Nurse Practitioner | 4981026176 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018030570 | MO | MD | Registered Nurse |
| 2020016174 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Health, Inc | Current |
Accepting new patients | |
| Compass Health, Inc | Current |
Accepting new patients |
Locations
1800 Community
#B
Clinton, MO 64735
1800 Community
Clinton, MO 64735
Phone (660) 885-8131
114 Downey Pl
Cuba, MO 65453
Phone (573) 885-3358
101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555
1780 Old Highway 50 E
Ste 111
Union, MO 63084
Phone (636) 584-0305
1780 Old Highway 50 E
Ste 102
Union, MO 63084
Phone (636) 583-1611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2018030570 | MO | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2020016174 | MO | Yes |
Addresses
Primary practice location
101 Progress Pkwy
Sullivan, MO 63080-2359
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131
Other practice location 1
1780 Old Highway 50 E Ste 102
Union, MO 63084-3397
Phone (888) 403-1071
Other practice location 2
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 364-9000
Other practice location 3
1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899
Other providers in Sullivan, MO
- Thomas James Jackson
- Shelley Jannings
- Jarco Inc
- Jarco, Inc.
- Christopher Lloyd Jeffrey
- Brianna Louise Keen
- Rani Kleinlein
- Tae Ho Kong
- Kathleen Laura Kramer
- Tanya Kreutz
All providers in Sullivan, MO · Psychiatric/Mental Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.