Kathleen Annette Keogh, RN, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R117190-9 Issued in MN

Practice address

1055 Westgate Dr
Saint Paul, MN 55114-1065

Phone

(651) 635-9173

Fax

(612) 262-7989

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evercare Collaborative Solutions Inc

  • Registered Nurse
  • Minnetonka, MN
  • NPI 1285686378
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1013067610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16183 TAHINKA PL NW",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 WESTGATE DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141065",
            "telephone_number": "651-635-9173",
            "fax_number": "612-262-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOGH",
        "first_name": "KATHLEEN",
        "middle_name": "ANNETTE",
        "credential": "RN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R117190-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027328-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Nicole Kent, MA, OTR/L
• Jay E Kent, MD
• Josie Kent
• Susan Marie Kent, D.C.
• Amanda K Keogh, ANP-BC
• Khounkham Keovilaj
• Kimberly Keppen, MA, LPCC
• Brigette Robbins Kerber, PA-C
• Chase Franklin Kerber, DPT
• Lenaya Terrill Kerlin, LPCC

• Gerontology Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.