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Jacob R Keller , LPCC

Counselor - Professional β€’ Eaton, OH

Active NPI 1629340856 Individual Practitioner Male Practitioner
Practice location in NPPES

411 W Main St
Eaton, OH 453201624

Call 9374759124 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

411 W Main St

Eaton, OH 453201624

Telephone 9374759124

NPI first issued

2012

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Jacob Keller has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Jacob Keller as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Eaton and Ohio

4 active clinicians are listed under Counselor - Professional with a practice address in Eaton, OH (6,790 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-09-12
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES OH E1000620
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20240110004838

Enrollment State Jurisdiction

OH

PECOS Control ID

0547611899

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location September 12, 2023

Registered at 411 W MAIN ST, EATON, OH 453201624 (Tel: 9374759124)

πŸ“
Updated Business Mailing Address September 12, 2023

Registered at 411 W MAIN ST, EATON, OH 453201624 (Tel: 9374759124)

πŸ‘€
Provider Name / Credentials Updated September 12, 2023

Recorded as JACOB KELLER, LPCC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 12, 2023

Counselor (license number reported to NPPES: OH E1000620)

βœ…
NPI Profile Active February 03, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 03, 2012

Registered at 601 S EDWIN C MOSES BLVD, NW BLDG 4TH FLOOR, DAYTON, OH 454173424 (Tel: 9377348333)

πŸ“
Business Mailing Address (Initial Record) February 03, 2012

Registered at 2172A US ROUTE 127 N, EATON, OH 453209289 (Tel: 9374561915)

πŸ‘€
Provider Name / Credentials (Initial Record) February 03, 2012

Recorded as JACOB KELLER

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 03, 2012

Counselor (license number reported to NPPES: OH C1000620)

🟒
Initial NPI Registration & Enumeration February 03, 2012

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1629340856
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 03, 2012
Last Update: September 12, 2023
Sole Proprietor: Yes

Mailing Address

411 W Main St

Eaton, OH 453201624

Phone: 9374759124

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.