Individual provider Active NPI

Priya Keane, DNP, AG-ACNP-BC

  • Acute Care Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1023502606
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
159071 Issued in AK
Practice address
3200 Providence Dr Ste 111
Anchorage, AK 99508-4662
Phone
(907) 212-7890
NPI assigned
Jun 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 201392788RN OR
Acute Care Nurse Practitioner 363LA2100X 159071 AK Primary

Addresses

Primary practice location

3200 Providence Dr Ste 111
Anchorage, AK 99508-4662

Mailing address

1002 W 15TH Ave
Anchorage, AK 99501-4942
Phone (918) 260-5698

Other practice location 1

3600 N Interstate Ave
Portland, OR 97227-1106
Phone (503) 285-9321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200806000996 AK Practitioner - Nurse Practitioner 7113342288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 562-2211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201392788RNORMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jul 20, 2020 Accepting new patients

Locations

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

3200 Providence Dr
Ste 111
Anchorage, AK 99508
Phone (907) 212-7890

3200 Providence Dr
Ste B111
Anchorage, AK 99508
Phone (907) 212-7890

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1023502606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 W 15TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995014942",
            "telephone_number": "918-260-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PROVIDENCE DR STE 111",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084662",
            "telephone_number": "907-212-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 N Interstate Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271106",
            "country_code": "US",
            "telephone_number": "503-285-9321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANE",
        "first_name": "PRIYA",
        "credential": "DNP, AG-ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "201392788RN",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AK",
            "license": "159071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.