SUSAN KELLER (NPI# 1104201813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104201813 |
| Entity Type | Individual |
| Full Name | SUSAN KELLER |
| Practice Address |
6551 Harris Pkwy Ste 250 Fort Worth TX 76132 |
| Mailing Address |
6551 Harris Pkwy Ste 250 Fort Worth TX 76132-6115 |
| Practice Telephone | 7138241883 |
| Mailing Telephone | 7138241883 |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2019-01-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA09894 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4819 River Oaks Blvd, Fort Worth, TX 76114 | 8176269744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699104059 | Susan Marie Keller | Speech-Language Pathologist | 3656 Mull Dr., Dove Healthcare - South, Eau Claire, WI 54701 | 2013-11-06 |
| 1215048327 | Susan Kathleen Kiener Keller | Counselor | 1011 W Springfield Ave, Urbana, IL 61801-3022 | 2006-08-31 |
| 1760436125 | Susan Clark Keller | Social Worker | 307 1st Ave East, Ste 3, Kalispell, MT 59901-4965 | 2006-05-20 |
| 1508200338 | Susan Kay Keller | Counselor | 4001 W Dayton St, Mchenry, IL 60050-8377 | 2013-04-23 |
| 1336416239 | Susan M Keller | Pharmacist | 835 Van Houten Ave, Clifton, NJ 07013-1930 | 2011-11-20 |
| 1124144340 | Susan M. Keller | Counselor | 20 E 13th Ave, Eugene, OR 97401-3535 | 2007-03-21 |
| 1871688721 | Susan Keller | Psychologist | 631 Tennessee St, Vallejo, CA 94590-4432 | 2006-10-04 |
| 1962514091 | Susan Lynn Keller | Specialist | 2615 E Clinton Ave, Fresno, CA 93703-2223 | 2006-08-31 |
| 1598736514 | Susan Keller | Nurse Practitioner | 130 Lincoln Place Ct, Belleville, IL 62221-5884 | 2006-01-28 |
| Street Address |
6551 HARRIS PKWY STE 250 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174924450 | David Maldonado IIi Md Pa | Internal Medicine | 6551 Harris Pkwy Ste 250, Fort Worth, TX 76132-6115 | 2014-09-05 |
| 1982224127 | Kristina Mae Holmquist | Nurse Practitioner | 6551 Harris Pkwy Ste 250, Fort Worth, TX 76132-6115 | 2020-04-17 |
| 1629557301 | Jon Moench | Specialist/Technologist, Other | 6551 Harris Pkwy Ste 250, Fort Worth, TX 76132-6115 | 2018-08-13 |
| 1053810127 | Cody Rodriguez | Nurse Practitioner | 6551 Harris Pkwy Ste 250, Fort Worth, TX 76132-6115 | 2018-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669843 | Rubilene Spinks | Pharmacist | 6300 Oakmount Blvd, Fort Worth, TX 76132 | 2020-11-03 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1568029320 | Ty Desilets | Physical Therapist | 5959 Bryant Irvin Rd Suite 100, Fort Worth, TX 76132 | 2019-05-28 |
| 1750844049 | Fort Worth Surgical Center Lp | Clinic/Center | 6949 Bryant Irvin Road, Fort Worth, TX 76132 | 2019-04-12 |
| 1063971232 | Symetria Health of Texas, LLC | Clinic/Center | 7299 Hawkins View Drive, Fort Worth, TX 76132 | 2019-03-18 |
| 1275015612 | Falguni Udayan Patel | Nurse Practitioner | 6100 Harris Pkwy Ste 1230, Fort Worth, TX 76132 | 2018-09-02 |
| 1881110161 | Because De Cares | Private Vehicle | 7101 Bryant Irving Road #33104, Fort Worth, TX 76132 | 2017-08-17 |
| 1871045708 | Cns - F.w., LLC | Clinic/Center | 6940 Harris Parkway, Fort Worth, TX 76132 | 2016-10-26 |
| 1790233294 | Prime Diagnostic Imaging of Fort Worth, LLC | Clinic/Center | 6491 Southwest Blvd., Benbrook, TX 76132 | 2016-09-14 |
| Find all providers in zip 76132 | ||||
| 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 |
|---|---|---|---|---|
| 1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
| 1629681952 | Anum Bashwani | Physician Assistant | 5601 Bridge St Ste 450, Fort Worth, TX 76112-2305 | 2020-08-26 |
| 1780200881 | Emily Brown Holloway | Physician Assistant | 1904 Turner Ridge Dr Apt 5202, Fort Worth, TX 76110-2499 | 2020-06-24 |
| 1679196570 | Maria Cristela Mosso | Physician Assistant | 4521 S Hulen St Ste 118, Fort Worth, TX 76109-4954 | 2020-05-26 |
| 1679195978 | Jacob Torre | Physician Assistant | 1701 River Run Ste 1118, Fort Worth, TX 76107-6557 | 2020-05-11 |
| 1871122382 | Kenaud Jeune | Physician Assistant | 5817 Fairglen Ave Apt 312, Fort Worth, TX 76137-6810 | 2020-04-06 |
| 1922635648 | Lauren Elizabeth Studey | Physician Assistant | 3470 Sagecrest Ter, Fort Worth, TX 76109-2555 | 2020-03-24 |
| 1033743612 | James Bregg Reedy | Physician Assistant | 200 W Magnolia Ave Ste 201, Fort Worth, TX 76104-7657 | 2020-02-24 |
| 1992335194 | Alexandria Christine Rios | Physician Assistant | 5904 Rockhill Rd, Fort Worth, TX 76112-3047 | 2020-01-16 |
| 1982253605 | Kelly Ann Klein | Physician Assistant | 6708 River Bend Rd, Fort Worth, TX 76132-1108 | 2019-09-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76132 |
Please comment or provide details below to improve the information on SUSAN 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.