Individual provider Active NPI

Edweana Katrice Keller, FNP-C

  • Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1033910989
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5021836 Issued in NC
Practice address
2400 W Friendly Ave
Greensboro, NC 27403-1109
Phone
(336) 420-1055
NPI assigned
Mar 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5021836 NC Primary
Family Nurse Practitioner 363LF0000X 5021836 NC

Addresses

Primary practice location

2400 W Friendly Ave
Greensboro, NC 27403-1109

Mailing address

2400 W Friendly Ave
Greensboro, NC 27403-1109
Phone (336) 420-1055

Other practice location 1

3711 Elmsley St Ste 101
Greensboro, NC 27406-7039
Phone (336) 890-2165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260326003892 NC Practitioner - Nurse Practitioner 7315422474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3711 Elmsley St
Suite 101
Greensboro, NC 27406-7039
Phone (336) 890-2165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5021836NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation PastSince Jul 7, 2026 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation PastSince Jul 7, 2026 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1033910989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W FRIENDLY AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031109",
            "telephone_number": "336-420-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W FRIENDLY AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031109",
            "telephone_number": "336-420-1055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3711 Elmsley St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274067039",
            "country_code": "US",
            "telephone_number": "336-890-2165",
            "fax_number": "336-890-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "EDWEANA",
        "middle_name": "KATRICE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5021836",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.