AMBER BREWER KELLER (NPI# 1164779997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164779997 |
| Entity Type | Individual |
| Full Name | AMBER BREWER KELLER |
| Credential | PA-C |
| Practice Address |
4618 Country Club Rd Winston Salem NC 27104-3520 |
| Mailing Address |
Medical Center Blvd Wfu School of Medicine Department of Dermatology Winston Salem NC 27157-0001 |
| Practice Telephone | 3367161763 |
| Mailing Telephone | 3367162255 |
| Mailing Fax Number | 3367169258 |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2012-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-03575 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8102742 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417509647 | Amber Marie Keller | Physician Assistant | 9498 William Penn Hwy, Huntingdon, PA 16652-7167 | 2019-07-09 |
| 1780154054 | Amber Nichole Keller | Behavior Technician | 100 Congress Ave Ste 2000, Austin, TX 78701-2745 | 2018-11-29 |
| Street Address |
4618 COUNTRY CLUB RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104-3520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720063175 | Steven Richard Feldman | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-08 |
| 1487213047 | Diana Isabel Munoz Ali | Nurse Practitioner | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2019-06-07 |
| 1629544689 | Kimberly Kincaid Mcpeeks | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2018-10-17 |
| 1861842031 | Leonora Culp Bomar | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2016-06-17 |
| 1912392903 | Melissa Brooke Hoffman | Student in an Organized Health Care Education/Training Program | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2015-04-06 |
| 1083031090 | Jessica Alexis Savas | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2014-03-27 |
| 1629272455 | William Wei-ting Huang | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2007-06-14 |
| 1841228335 | Adele Clark | Physician Assistant | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2006-06-30 |
| 1316923360 | Joseph Lucius Jorizzo | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-21 |
| 1518943943 | Phillip Mabon Williford | Dermatology | 4618 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| Find all providers in zip 27104 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375032 | Anthony Gentile | Physician Assistant | 2632 Wynbrook Dr, Winston Salem, NC 27103-8005 | 2020-08-07 |
| 1376152074 | Meera Shah | Physician Assistant | 3288 Robinhood Rd Ste 202, Winston Salem, NC 27106-5464 | 2020-07-28 |
| 1770118457 | Heather Leigh Bissell | Physician Assistant | 153 Lavender Ln, Winston Salem, NC 27107-6023 | 2020-03-03 |
| 1245899806 | Cheryl L Sizer | Physician Assistant | Wake Forest Baptist Health 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2019-06-07 |
| 1235606575 | Vincent James Alderete | Physician Assistant | Wake Forest Baptist Health 1 Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2018-10-25 |
| 1386127538 | Frederick Keith Stirewalt | Physician Assistant | Medical Center Blvd Faithhealth, Winston Salem, NC 27157-0001 | 2018-09-13 |
| 1164936852 | Lindsay Webster | Physician Assistant | 10479 Nc-109, 107a, Winston Salem, NC 27107 | 2017-11-17 |
| 1518477694 | Raul Canchari Ames | Physician Assistant | 512 Waughtown St, Winston Salem, NC 27127-2236 | 2017-10-03 |
| 1922528611 | Devon Adams | Physician Assistant | 1 Medical Center Blvd Gastroenterology Dept, Winston Salem, NC 27157-7223 | 2017-06-22 |
| 1053862474 | Seguin Warwick Beuerlein | Physician Assistant | 2425 Riley Forest Dr, Winston Salem, NC 27127-7573 | 2016-10-20 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
Please comment or provide details below to improve the information on AMBER BREWER KELLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.