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Deactivated NPI 1265520860 Deactivated / Inactive NPI Female Practitioner

Candace Keller

Dietitian, Registered • Fosston, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Candace Keller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 10, 2006
NPI Deactivation Date January 14, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Candace Keller was a registered Dietitian, Registered practicing in Fosston, MN. Throughout an active medical career spanning 13 years, Candace Keller provided care at the practice location at 900 HILLIGOSS BLVD SE until profile deactivation on 2019-01-14.

Practice Location & Contact Primary Location

Practice Address

900 Hilligoss Blvd Se

Fosston, MN 565421542

Telephone 2184351133
Fax 2184351134
Associated Practice Facility / Clinic
🏢 First Care Medical Services Facility NPI 1497850119

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Fosston, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Fosston, MN (1611 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License MN 1187

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Breah Christianson , FNP

Nurse Practitioner - Family

NPI 1013745892

Family Nurse Practitioner

NPI 1174613012

Physician Assistant (Certified)

Laurence Yunker , CRNA

Nurse Anesthetist, Certified Registered

NPI 1205934742

Certified Registered Nurse Anesthetist

Dr. Shyanne Loiland , DPT

Physical Therapist

NPI 1336074574

Doctor of Physical Therapy

Debra Severson , FNP

Nurse Practitioner - Family

NPI 1336238724

Family Nurse Practitioner

Kristi Widseth , APRN, CRNA

Nurse Anesthetist, Certified Registered

NPI 1427122811

Advanced Practice Registered Nurse, Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 14, 2019

Record deactivated on January 14, 2019

NPI Profile Active November 09, 2012

NPI status registered as active in NPPES database

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Updated Practice Location November 09, 2012

Registered at 900 HILLIGOSS BLVD SE, FOSSTON, MN 565421542 (Tel: 2184351133)

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Updated Business Mailing Address November 09, 2012

Registered at 900 HILLIGOSS BLVD SE, FOSSTON, MN 565421542

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Provider Name / Credentials Updated November 09, 2012

Recorded as CANDACE KELLER

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 09, 2012

Dietitian, Registered (License #1187 in MN)

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Initial NPI Registration & Enumeration October 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265520860
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 10, 2006
Last Update: November 09, 2012
Deactivation Date: January 14, 2019

Mailing Address

900 Hilligoss Blvd Se

Fosston, MN 565421542

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.