JEFFERY P KELLER (CRNA) – Certified Registered Nurse Anesthetist, NPI 1063480713

JEFFERY P KELLER (CRNA) is a healthcare provider. based in Canton, Ohio. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. RN21447 (OH). The NPI Number for JEFFERY P KELLER (CRNA) is 1063480713

Main info

Male
34 Years Of Experience
Name
JEFFERY P KELLER (CRNA)
NPI
1063480713
Phone
(330) 363-7462
Address
2600 SIXTH STREET SW
Enumeration Date
9 March 2006
Last Update Date
13 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3304548076
Graduation Year
1992 (34 years ago)
PAC ID
4688709439
Group Practice PAC ID
1850726126
Professional Enrollment ID
I20100318000069

Contacts

Secure Messaging
Jeffery.Keller@direct.aultman.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

Provider Addresses for JEFFERY P KELLER (CRNA)

  • 2600 SIXTH STREET SW

    OHIO HOSPITAL BASED PHYSICIAN CORP

    CANTON, OH 44710

    Phone: (330) 363-7462

    Fax: (330) 363-7679

    Type: Mailing

  • PO BOX 80690

    CANTON, OH 447080690

    Phone: (330) 363-7444

    Fax: (330) 363-7770

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100318000069ICertified Registered Nurse Anesthetist (Crna)OHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00410Anesthesia for procedure to correct abnormal heart rhythm3029$0
View full utilization report →

Insurance plans in this area (ZIP 44710)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850726126View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)OH
Certified Clinical Nurse Specialist (Cns)OH
Nurse PractitionerOH
-OH
-OH
-OH
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
Nurse PractitionerOH
-OH

Reviews

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Frequently asked questions

What NPI should I save for JEFFERY P KELLER (CRNA)?
Save NPI 1063480713 if you need a stable reference for JEFFERY P KELLER (CRNA).
Is JEFFERY P KELLER (CRNA) currently active in the NPI registry?
CMS-published data lists JEFFERY P KELLER (CRNA) as an active registrant.
What field does JEFFERY P KELLER (CRNA) work in?
You can think of JEFFERY P KELLER (CRNA) as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where does public data place JEFFERY P KELLER (CRNA)?
The snapshot lists Canton, Ohio for JEFFERY P KELLER (CRNA); download NPPES for the complete set.
How can I contact JEFFERY P KELLER (CRNA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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