DR. NANCY KELLER (NPI# 1063496602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063496602 |
| Entity Type | Individual |
| Full Name | DR. NANCY KELLER |
| Credential | MD |
| Practice Address |
790 E 5th St Coquille OR 97423-1755 |
| Mailing Address |
1900 Woodland Dr Coos Bay OR 97420-0000 |
| Practice Telephone | 5413963111 |
| Practice Fax Number | 5413965891 |
| Mailing Telephone | 5412675151 |
| Mailing Fax Number | 5412664501 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2010-03-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD18038 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 043831 | 05 | |
| OR | NBMC NPI NUMBER-GROUP | 1407812365 | 01 |
| OR | RR MEDICARE GROUP NUMBER | CD8723 | 01 |
| OR | RR MEDICARE PTAN NUMBER | 080041637 | 01 |
| OR | MEDICARE GROUP PIN NUMBER | R0000WFBTV | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811556749 | Nancy Lee Keller | Marriage & Family Therapist | 2025 Westwind Dr Ste A, Bakersfield, CA 93301-3036 | 2019-06-13 |
| 1992026066 | Nancy Keller | Registered Nurse | 66 Fairway Ave, Riverhead, NY 11901-2308 | 2010-06-11 |
| 1235645813 | Nancy Carol Keller | Speech-Language Pathologist | 995 9th Ave Sw, Bessemer, AL 35022-4527 | 2017-12-19 |
| 1528219243 | Nancy C Keller | Social Worker | 100 Pinecrest Dr, Pineville, LA 71360-4276 | 2008-10-01 |
| 1871707695 | Nancy Lee Keller | Dietitian, Registered | 4580 S Lindbergh Blvd, Saint Louis, MO 63127-1810 | 2007-05-10 |
| 1831276245 | Nancy Jane Keller | Dietitian, Registered | 500 Foothill Blvd, Nutrition & Food Service (120), Salt Lake City, UT 84148-0001 | 2006-11-01 |
| Street Address |
790 E 5TH ST |
| City | COQUILLE |
| State | OR |
| Zip Code | 97423-1755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194336339 | Tiffany Brackus | Nurse Practitioner | 790 E 5th St, Coquille, OR 97423-1755 | 2020-08-12 |
| 1578189601 | Vanessa Noreen Mohrbacher | Nurse Practitioner | 790 E 5th St, Coquille, OR 97423-1755 | 2020-06-24 |
| 1164082988 | Amanda Krantz | Registered Nurse | 790 E 5th St, Coquille, OR 97423-1755 | 2019-06-14 |
| 1699276287 | Adam Clark | Social Worker | 790 E 5th St, Coquille, OR 97423-1755 | 2018-02-28 |
| 1861945487 | Julian Andres Ospina | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2016-07-31 |
| 1326428475 | Kriti Choudhary | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2015-06-04 |
| 1215356381 | Malissa Trojan | Social Worker | 790 E 5th St, Coquille, OR 97423-1755 | 2014-04-15 |
| 1538424346 | Paavani Atluri | Internal Medicine | 790 E 5th St, Coquille, OR 97423 | 2012-07-08 |
| 1265758973 | Brock W. Millet | Family Medicine | 790 E 5th St, Coquille, OR 97423-1755 | 2010-04-20 |
| 1083749394 | Susan K Sinnott | Marriage & Family Therapist | 790 E 5th St, Coquille, OR 97423-1755 | 2007-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457919003 | Julie Ann Hage | Registered Nurse | 306s Irving, Coquile, OR 97423 | 2019-05-30 |
| 1730417106 | Pahls Dentistry PC | Dentist | 346 N. Central Blvd, Coquille, OR 97423 | 2009-11-24 |
| 1730223967 | Coquille Valley Hospital District | General Acute Care Hospital | 940 East Fifth Street, Coquille, OR 97423 | 2007-02-19 |
| 1942366687 | Douglas Deverne Day | Dentist | 346 N Central, Coquille, OR 97423 | 2006-12-28 |
| 1417040023 | County of Coos Coos County School District R8 | Local Education Agency (LEA) | 790 W 17th St, Coquille, OR 97423 | 2006-10-02 |
| 1689650673 | Douglas Gordon Crane | Internal Medicine | 940 East Fifth Street East Wing, Coquille, OR 97423 | 2005-12-21 |
| 1164557179 | Coquille Valley Hospital District | Medicare Defined Swing Bed Unit | 940 E 5th St, Coquille, OR 97423 | 2007-02-22 |
| 1962824060 | Oregon Retina, LLP | Ophthalmology | 855 W Central Blvd, Coquille, OR 97423-1095 | 2014-01-09 |
| 1356594162 | Rebecca Marie Crawford | Case Manager/Care Coordinator | 585 W 4th Pl, Coquille, OR 97423-1150 | 2008-10-24 |
| 1073758389 | Glenda Gay Balneg | Physical Therapist | 279 N Central Blvd, Coquille, OR 97423-1241 | 2008-12-16 |
| Find all providers in zip 97423 | ||||
| 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 |
|---|---|---|---|---|
| 1922620558 | Coquille Valley Hospital District | Family Medicine | 940 E 5th St, Coquille, OR 97423-1666 | 2020-05-18 |
| 1861945487 | Julian Andres Ospina | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2016-07-31 |
| 1326428475 | Kriti Choudhary | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2015-06-04 |
| 1265758973 | Brock W. Millet | Family Medicine | 790 E 5th St, Coquille, OR 97423-1755 | 2010-04-20 |
| 1851351191 | Patrick Edwards | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2006-03-23 |
| 1467421156 | Edward Harman Piepmeier Jr. | Family Medicine | 790 E 5th St, Coquille, OR 97423-1755 | 2006-03-15 |
| 1306821731 | John William Brazer | Family Medicine | 790 E 5th St, Coquille, OR 97423-1755 | 2005-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306344 | Emily Herrmann | Family Medicine | 1965 Alder St, Eugene, OR 97405-2937 | 2020-11-03 |
| 1366041071 | Christina Cabelly | Family Medicine | 16305 Sw Loon Dr, Beaverton, OR 97007-8989 | 2020-10-23 |
| 1386242790 | Rose City Medical Clinic LLC | Family Medicine | 11397 Se Cascade View Ct, Clackamas, OR 97086-9753 | 2020-10-16 |
| 1346847332 | Jasmine Barnhart | Family Medicine | 1935 Canyon Ave, Medford, OR 97504-2128 | 2020-10-03 |
| 1255949434 | Deep Creek Family Medicine | Family Medicine | 39084 Proctor Blvd Ste A, Sandy, OR 97055-8064 | 2020-07-14 |
| 1316569635 | Doctors On Video | Family Medicine | 13215 Sw Hawks Beard St Apt 726, Tigard, OR 97223-2125 | 2020-05-08 |
| 1710510094 | Gresham Family Care Inc | Family Medicine | 1800 Blankenship Rd Ste 350, West Linn, OR 97068-4182 | 2020-02-14 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1083252472 | Driven Enterprises PC | Family Medicine | 20700 Wandalea Dr, Bend, OR 97701-1594 | 2019-12-16 |
| 1891331195 | Praxis Medical Group Inc | Family Medicine | 1426 Oak Street, Eugene, OR 97401-4043 | 2019-11-21 |
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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.