Active NPI
Logan J Keller, NP
- Family Nurse Practitioner
- Lake Charles, LA
National Provider Identifier
1962894212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP08215
- Practice address
- 2770 3Rd Ave Ste 110
Lake Charles, LA 70601-0404 - Phone
- (337) 494-4747
- Fax
- (337) 494-4773
- NPI assigned
- Feb 24, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP08215 | LA | Primary |
Addresses
Primary practice location
2770 3Rd Ave Ste 110
Lake Charles, LA 70601-0404
Mailing address
P O Box 122425 Dept 2425
Dallas, TX 75312-2425
Phone (337) 494-2921
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP08215 | Other | LA | STATE NP LICENSE |
| 2385810 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2770 3Rd Ave
Suite 110
Lake Charles, LA 70601-0404
Phone (337) 494-4747
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP08215 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LCMS Neurosurgical Institute of Lake Charles LLC | Current | Accepting new patients | |
| Lake Charles Medical Services | Past | Accepting new patients |
Locations
2770 3rd Ave
Ste 110
Lake Charles, LA 70601
Phone (337) 494-2750
1717 Oak Park Blvd
Fl 3
Lake Charles, LA 70601
Phone (337) 494-4900
2770 3rd Ave
Ste 100
Lake Charles, LA 70601
Phone (337) 494-4720
Interoperability endpoints
- lkeller5281992@direct.casso.us.com
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Lake Charles, LA
- NPI 1851526917
-
- Neurological Surgery Physician
- Lake Charles, LA
- NPI 1558305862
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sulphur, LA
- NPI 1083992382
-
- General Acute Care Hospital
- Sulphur, LA
- NPI 1093719932
-
- Multi-Specialty Clinic/Center
- Sulphur, LA
- NPI 1215560974
Hospital
-
- Otolaryngology/Facial Plastic Surgery Physician
- Sulphur, LA
- NPI 1366700387
Hospital
-
- Obstetrics & Gynecology Physician
- Sulphur, LA
- NPI 1619221348
Hospital
-
- Gastroenterology Physician
- Lake Charles, LA
- NPI 1285351411
Hospital
-
- Rheumatology Physician
- Lake Charles, LA
- NPI 1659424075
Hospital
-
- General Acute Care Hospital
- Lake Charles, LA
- NPI 1972549855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1962894212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 122425 DEPT 2425",
"city": "DALLAS",
"state": "TX",
"postal_code": "753122425",
"telephone_number": "337-494-2921",
"fax_number": "337-494-6523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2770 3RD AVE STE 110",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706010404",
"telephone_number": "337-494-4747",
"fax_number": "337-494-4773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLER",
"first_name": "LOGAN",
"middle_name": "J",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-24",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP08215",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE NP LICENSE",
"identifier": "AP08215",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2385810",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.