NPIMap

Organization Active NPI

Cary S Keller MD PC

  • Durable Medical Equipment & Medical Supplies
  • Fairbanks, AK
National Provider Identifier
1982805511
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
38793 Issued in AK
Legal business name
CARY S KELLER MD PC
Practice address
751 Old Richardson Hwy
Suite 200
Fairbanks, AK 99701-7813
Phone
(907) 451-6561
Fax
(907) 451-4847
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rebecca S Dean
Title
Executive Director
Phone
(907) 451-6561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 38793 AK Primary

Addresses

Primary practice location

751 Old Richardson Hwy
Suite 200
Fairbanks, AK 99701-7813

Mailing address

751 Old Richardson Hwy
Suite 200
Fairbanks, AK 99701-7813
Phone (907) 451-6561

Other identifiers 1

IdentifierTypeStateIssuer
MDG202MedicaidAK

Other names 1

  • Sportsmedicine Fairbanks Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982805511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 OLD RICHARDSON HWY",
            "address_2": "SUITE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017813",
            "telephone_number": "907-451-6561",
            "fax_number": "907-451-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 OLD RICHARDSON HWY",
            "address_2": "SUITE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017813",
            "telephone_number": "907-451-6561",
            "fax_number": "907-451-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARY S KELLER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "907-451-6561"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AK",
            "license": "38793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MDG202",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sportsmedicine Fairbanks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.