DR. KEITH LINCOLN KELLER (NPI# 1477843282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477843282 |
| Entity Type | Individual |
| Full Name | DR. KEITH LINCOLN KELLER |
| Credential | M.D., R.PH. |
| Practice Address |
Ihs Pine Ridge Service Unit Hwy 18 Pine Ridge SD 57770 |
| Mailing Address |
Po Box 203 Pine Ridge SD 57770-0203 |
| Practice Telephone | 6058673195 |
| Mailing Telephone | 4022384913 |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2018-04-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 16677 | NE | Allopathic & Osteopathic Physicians |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
145651-1701 | UT | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
11551 | CO | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
10573 | NE | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Ihs North 107-202, Pine Ridge, SD 57770 | 4022384913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366834251 | Keith Keller | Counselor | 928 Main St, Keokuk, IA 52632-4655 | 2015-03-02 |
| 1700179710 | Keith Cyrus Keller | Dentist | 4010 82nd St, Elmhurst, NY 11373-1305 | 2011-05-24 |
| Street Address |
IHS PINE RIDGE SERVICE UNIT HWY 18 |
| City | PINE RIDGE |
| State | SD |
| Zip Code | 57770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508427352 | Apollo Medflight, LLC | Ambulance | 12 Airport Rd, Pine Ridge, SD 57770 | 2019-06-24 |
| 1740795780 | Oglala Sioux Tribe Air Rescue | Ambulance | Pine Ridge Comprehensive Hospital: 1201 E. Highway 18th, Pineridge, SD 57770 | 2017-12-13 |
| 1841546264 | Sharla Laurene Roth | Pharmacist | E Highway 18, Pine Ridge, SD 57770 | 2012-08-03 |
| 1992024137 | Jackalyn Spry | Radiologic Technologist | 4500 E Hwy 18, Pine Ridge, SD 57770 | 2010-05-27 |
| 1063666071 | Virginia Horn | Registered Nurse | 1201 East Highway 18, Pine Ridge, SD 57770 | 2008-11-05 |
| 1881854602 | Melva A Clifford | Registered Nurse | 4500 Main Street, Pine Ridge, SD 57770 | 2008-06-16 |
| 1487814513 | Rodney R Sahr | Registered Nurse | Hwy 18 East, Pine Ridge Hospital, Pine Ridge, SD 57770 | 2008-06-12 |
| 1770743924 | Maneen Baker | Registered Nurse | Pine Ridge Ihs, Us Hwy 18, Pine Ridge, SD 57770 | 2008-06-11 |
| 1871752139 | Patricia Jane Broberg | Registered Nurse | Us Hwy 18, Pine Ridge, SD 57770 | 2008-06-03 |
| 1598948242 | Carey Anne Maccarthy | Counselor | 1201 Hwy 18 East, Pine Ridge Sd, SD 57770 | 2007-12-17 |
| Find all providers in zip 57770 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689191363 | Ryan Anthony Waybright | Pharmacist | Po Box 5045, Sioux Falls, SD 57117-5045 | 2017-08-24 |
| 1699914523 | Timothy John Dodson | Pharmacist | 21633 Custer Trl, Nemo, SD 57759-7609 | 2009-02-17 |
| 1972102952 | Jessica Kotschegarow | Pharmacist | 2100 Broadway Ave, Yankton, SD 57078-1705 | 2020-10-21 |
| 1790383479 | Heather Opdahl | Pharmacist | Hy-vee Pharmacy, 1320 9th Ave Se, Watertown, SD 57201 | 2020-10-14 |
| 1043845829 | Susan Mary Burbach | Pharmacist | 525 W Cherry St, Vermillion, SD 57069-1141 | 2020-03-11 |
| 1871137083 | Brandon David Hubert | Pharmacist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2019-10-30 |
| 1972159101 | Harrison Charles Johnson | Pharmacist | 113 Comanche Rd, Fort Meade, SD 57741-1002 | 2019-08-13 |
| 1124510771 | Cassie M Schmidt | Pharmacist | 500 N 5th St, Hot Springs, SD 57747-1480 | 2018-05-30 |
| 1902314990 | Robert Sayles | Pharmacist | 2501 W 22nd St, Sioux Falls, SD 57105-1305 | 2018-01-12 |
| 1710493507 | Karen M Richart | Pharmacist | 1730 N Garfield Ave, Pierre, SD 57501-5507 | 2017-12-16 |
| Find all providers with the same taxonomy | ||||
| City | PINE RIDGE |
| Zip Code | 57770 |
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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.