Shelly D Keller, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Lake Winnebago, Missouri. Her current practice location is
120 Cherokee Ln, Lake Winnebago, Missouri. You can reach out to her office (for appointments etc.) via phone at
(816) 623-9711.
Shelly D Keller is licensed to practice in Missouri (license number 2009014918) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063642700.
Healthcare Provider's Profile
Full Name | Shelly D Keller |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 120 Cherokee Ln, Lake Winnebago, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063642700
- Provider Enumeration Date: 07/15/2009
- Last Update Date: 07/15/2009
Medicare PECOS Information:
- PECOS PAC ID: 9032263306
- Enrollment ID: I20241030004023
Medical Identifiers
Medical identifiers for Shelly D Keller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063642700 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 2009014918 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shelly D Keller is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shelly D Keller, LCSW 120 Cherokee Ln, Lake Winnebago, MO 64034-9304 Ph: (816) 623-9711 | Shelly D Keller, LCSW 120 Cherokee Ln, Lake Winnebago, MO 64034-9304 Ph: (816) 623-9711 |
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