Active NPI
Case Keltner
- Public Health & General Preventive Medicine Physician
- Fort George G Meade, MD
National Provider Identifier
1962050013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 0101277441
- Practice address
- Usameddac 2480 Llewellyn Ave
Fort George G Meade, MD 20755 - Phone
- (301) 677-8800
- NPI assigned
- Sep 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101277441 | VA | |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 0101277441 | VA | Primary |
Addresses
Primary practice location
Usameddac 2480 Llewellyn Ave
Fort George G Meade, MD 20755
Mailing address
Usameddac 2480 Llewellyn Ave
Fort George G Meade, MD 20755
Phone (301) 677-8800
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 |
|---|---|---|---|
| 0101277441 | VA | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1962050013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "USAMEDDAC 2480 LLEWELLYN AVE",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "20755",
"telephone_number": "301-677-8800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USAMEDDAC 2480 LLEWELLYN AVE",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "20755",
"telephone_number": "301-677-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELTNER",
"first_name": "CASE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-02",
"last_updated": "2024-07-18",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101277441",
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "VA",
"license": "0101277441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort George G Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.