JOHN A KELLER (NPI# 1962462937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962462937 |
| Entity Type | Individual |
| Full Name | JOHN A KELLER |
| Credential | MD |
| Practice Address |
108 North Park Dr Fayetteville GA 30214 |
| Practice Telephone | 7704613466 |
| Practice Fax Number | 7704613884 |
| Mailing Telephone | 7704613466 |
| Mailing Fax Number | 7704613884 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2016-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 00007369 | AL | Other Service Providers |
| N | 174400000X | Specialist | 20555 | GA | Other Service Providers |
| Y | 207Q00000X | Family Medicine | 20555 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | BCBS OF GA | 52144193 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912281965 | John B Keller | Dentist | 1701 Clearwater Ave, Suite B, Bloomington, IL 61704-6433 | 2011-10-07 |
| 1639212145 | John C Keller | Physical Therapist | 4601 Lake Boone Trl Ste 2e, Raleigh, NC 27607-7518 | 2007-02-14 |
| 1063563138 | John L Keller | Pharmacist | 500 Hwy 72nd West Rolla, Hillcrest Shopping Ctr, Rolla, MO 65401 | 2007-01-16 |
| 1588714141 | John Joseph Keller | Dentist | 552 East Main Street, Anoka, MN 55303 | 2007-01-12 |
| 1760562334 | John David Keller Iv | Dentist | 4920 Hononegah Rd, Roscoe, IL 61073-7778 | 2006-10-17 |
| 1770549065 | John L Keller | Chiropractor | 2988 W Huntsville Ave, Ste. C, Springdale, AR 72762-7726 | 2006-04-25 |
| 1578556726 | John W Keller | Plastic Surgery | 1130 W 4th St Ste 3202, Lawrence, KS 66044-1328 | 2005-08-23 |
| 1467956433 | John Keller | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Emergency Medicine, Los Angeles, CA 90095-7419 | 2018-03-22 |
| 1316488463 | John Keller | Physician Assistant | 2211 E Franklin Blvd, Ste 100, Gastonia, NC 28054-4985 | 2017-03-08 |
| 1548674831 | John Keller | Physical Therapist | 4812 E 33rd St, Tulsa, OK 74135-2038 | 2014-06-16 |
| Street Address |
108 NORTH PARK DR |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169185 | Raheem Lalani | Family Medicine | 230 Fieldstone Way, Fayetteville, GA 30215-8170 | 2020-06-18 |
| 1821619370 | Kelly R. Mccarty | Family Medicine | 5872 W Bannister Dr, Fayetteville, AR 72704-6536 | 2020-05-06 |
| 1720620230 | Vector Health and Wellness, LLC | Family Medicine | 1267 N Steamboat Dr Ste 3, Fayetteville, AR 72704-7148 | 2019-10-16 |
| 1295382182 | Nimota Motunrayo Akintoye | Family Medicine | 140 Briergate Pl, Fayetteville, GA 30214-3931 | 2019-08-24 |
| 1609332725 | Fastmed Health Nc, Pllc | Family Medicine | 150 Francam Dr, Fayetteville, NC 28311-4500 | 2019-02-13 |
| 1013486638 | K E Management Services | Family Medicine | 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703-4995 | 2018-11-14 |
| 1659896751 | Melissa Holt | Family Medicine | 108 Medical Center Blvd Ste G-50, Fayetteville, TN 37334-2741 | 2017-08-09 |
| 1124477484 | Mark William Guelzow | Family Medicine | 4101 Medical Center Dr Ste 1c, Fayetteville, NY 13066-6600 | 2016-06-08 |
| 1962865659 | Tracie Fullove | Family Medicine | 3162 W Martin Luther King Blvd Ste 13-14, Fayetteville, AR 72704-7679 | 2016-03-31 |
| 1053778936 | Linda Nancy Robinson | Family Medicine | 7107 Thorntree Hill Dr, Fayetteville, NY 13066-9790 | 2016-01-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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| 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.