JARED BRENT KELLER (NPI# 1861822439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861822439 |
| Entity Type | Individual |
| Full Name | JARED BRENT KELLER |
| Credential | P.A. |
| Practice Address |
1024 8th St Rupert ID 83350-1306 |
| Practice Telephone | 2086507941 |
| Practice Fax Number | 2084360735 |
| Mailing Telephone | 2086507941 |
| Mailing Fax Number | 2084360735 |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2015-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-1256 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MISSOURI LICENSE 2013041111 | 2013041111 | 01 |
| Street Address |
1024 8TH ST |
| City | RUPERT |
| State | ID |
| Zip Code | 83350-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578550547 | Janet King | Family Medicine | 1024 8th St, Rupert, ID 83350-1306 | 2005-10-04 |
| 1194158246 | Toni R Miller | Nurse Practitioner | 1024 8th St, Rupert, ID 83350-1306 | 2013-08-13 |
| 1669672333 | Jessica Shirley Gaby | Dental Hygienist | 1024 8th St, Rupert, ID 83350-1306 | 2007-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417349515 | Robbie Joe Carroll | Registered Nurse | 1024 8th Street, Family Health Services, Rupert, ID 83350 | 2015-02-26 |
| 1285921643 | Duane Broderick | Counselor | 2311 Parke Ave., Ste. 8, Burley, ID 83350 | 2011-07-06 |
| 1598798282 | Kerry W Saurey | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| 1093761694 | Family Health Services Corporation | Dental Hygienist | 402 6th St, Rupert, ID 83350 | 2006-05-25 |
| 1376531004 | Jeffrey Scott Swenson | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2005-10-06 |
| 1205312774 | Shawna M Mccaffrey | Nurse Practitioner | 1308 8th St, Rupert, ID 83350 | 2018-07-17 |
| 1386872810 | Brian R Muir | Family Medicine | 1308 8th St Ste 1, Rupert, ID 83350 | 2009-06-23 |
| 1083816334 | Cameron Mchan | Nurse Practitioner | 1308 8th St Ste 1, Rupert, ID 83350 | 2007-05-31 |
| 1134225956 | Margo Saunders | Specialist | 1308 8th St Ste 1, Rupert, ID 83350 | 2006-09-16 |
| 1619900305 | Don C Pates | Family Medicine | 1218 9th St, Ste 7, Rupert, ID 83350 | 2006-07-08 |
| Find all providers in zip 83350 | ||||
| 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 |
|---|---|---|---|---|
| 1437408416 | Heather Jill Simonson | Physician Assistant | 1218 9th St, Ste 12, Rupert, ID 83350-2207 | 2012-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695792 | Chelsea Dylan Tennent | Physician Assistant | 1666 E Gentlewind St, Boise, ID 83706-5914 | 2020-10-05 |
| 1922615848 | Allison Cluff | Physician Assistant | 1320 Bennett Ave, Burley, ID 83318-2665 | 2020-09-24 |
| 1245846187 | Adam Baker | Physician Assistant | 271 Jefferson St, Blackfoot, ID 83221-1818 | 2020-09-16 |
| 1265045199 | Julia Claire Brodie | Physician Assistant | 2352 N Apple Ln, Pocatello, ID 83204-7231 | 2020-08-29 |
| 1326651035 | Jenna Marie Castillo | Physician Assistant | 150 Taft Ave, Pocatello, ID 83201-5140 | 2020-08-24 |
| 1174148696 | Colton Jason Randall | Physician Assistant | 3885 Orchard Cir, Ammon, ID 83406-4656 | 2020-06-10 |
| 1871114553 | Samantha Tess Goodrich | Physician Assistant | 721 E Lenz St, Boise, ID 83712-7846 | 2020-05-04 |
| 1174164305 | Tessie Mari Mcinnally | Physician Assistant | 3015 E Magic View Dr # 115, Meridian, ID 83642-3743 | 2019-09-29 |
| 1013562305 | Brianna Suzanne Berg | Physician Assistant | 12535 N Fawn Ct, Hayden, ID 83835-8827 | 2019-08-05 |
| 1003376559 | Kodie Thomas | Physician Assistant | 2086 Picket Ln, Emmett, ID 83617-9104 | 2019-03-21 |
| Find all providers with the same taxonomy | ||||
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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.