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MR. TERRY RAY KELLER LPC, CADC I
NPI 1003117474
Counselor - Mental Health in Clackamas, OR

Active since November 16, 2010PECOS Enrolled
10180 SE SUNNYSIDE RD FL 1, CLACKAMAS, OR 97015(503) 571-0860(503) 571-0864 Get Directions Write a Review

NPPES record last updated: July 17, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 18, 2018, Oct 19, 2016 (2 updates tracked since 2016).

About Mr. Terry Ray Keller Lpc, Cadc I NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TERRY RAY KELLER LPC, CADC I (NPI 1003117474) is an individual mental health provider in Clackamas, Oregon, licensed in Oregon (C4173) and active in the NPI registry since November 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003117474
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. TERRY RAY KELLERCredential: LPC, CADC I
Location Address10180 SE SUNNYSIDE RD FL 1Clackamas, OR 97015-8970
Mailing Address500 Ne Multnomah St Ste 100Portland, OR 97232-2099 · (800) 813-2000
Phone(503) 571-0860
Fax(503) 571-0864
Sole ProprietorNo
Enumeration DateNovember 16, 2010
Last NPPES UpdateJuly 17, 20252 updates tracked since enumeration
NPPES CertifiedJuly 17, 2025
✔ NPI 1003117474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OR · C4173
10180 SE SUNNYSIDE RD FL 1, Clackamas, OR 97015
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Terry Ray Keller Lpc, Cadc I is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Terry Keller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Northwest
0.3 mi
Sleep Disorder Diagnostic
9717 SE SUNNYSIDE RD, 3RD FLOOR
Clackamas, OR 97015
  • Reassigned Medicare billing, Oregon enrollment
  • 3,207 clinicians in this Medicare group
NPI 1174851505 (503) 659-2454

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN EDGERTON
Counselor (Addiction (Substance Use Disorder))
10180 SE SUNNYSIDE RD FL 1
CLACKAMAS, OR 97015
Clackamas County (503) 571-0884
KAISER PERMANENTE
General Acute Care Hospital
10180 SE SUNNYSIDE RD FL 1
CLACKAMAS, OR 97015
Clackamas County (503) 571-0884

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Terry Keller's NPI number?

The NPI number for Terry Keller is 1003117474. It was assigned to this individual provider in the NPPES registry on November 16, 2010.

Where is Terry Keller located?

Terry Keller practices at 10180 SE Sunnyside Rd Fl 1, Clackamas, OR 97015. The listed phone number is (503) 571-0860.

What is Terry Keller's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Terry Keller enrolled in Medicare?

Yes. Terry Keller is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Terry Keller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Terry Keller reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Clackamas, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Terry Keller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Terry Keller was last updated on July 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.