Active NPI
Kenyatta Douglas
- Nurse's Aide
- Indianapolis, IN
National Provider Identifier
1023201381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 48010503137
- Practice address
- 8060 Knue Rd
Suite 110 General Healthcare Resources in
Indianapolis, IN 46250 - Phone
- (317) 842-7435
- Fax
- (317) 842-7674
- NPI assigned
- Aug 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 48010503137 | IN | Primary |
Addresses
Primary practice location
8060 Knue Rd
Suite 110 General Healthcare Resources in
Indianapolis, IN 46250
Mailing address
8060 Knue Rd
Suite 110
Indianapolis, IN 46250
Phone (317) 842-7435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48010503137 | IN | MD | Nurse's Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Healthcare Resources | Nurse'S Aide | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1124239132
Nurse'S Aide
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1023201381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8060 KNUE RD",
"address_2": "SUITE 110",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46250",
"telephone_number": "317-842-7435",
"fax_number": "317-842-7674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8060 KNUE RD",
"address_2": "SUITE 110 GENERAL HEALTHCARE RESOURCES IN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46250",
"telephone_number": "317-842-7435",
"fax_number": "317-842-7674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "KENYATTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "IN",
"license": "48010503137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.