Individual provider Active NPI

Tammy F. Keaton, CFNP

  • Nurse Practitioner
  • Beckley, WV
National Provider Identifier
1053354969
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0387963 Issued in WV
Practice address
1710 Harper Rd
Beckley, WV 25801-3357
Phone
(304) 256-4100
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0387963 WV Primary

Addresses

Primary practice location

1710 Harper Rd
Beckley, WV 25801-3357

Mailing address

PO Box 39
Slab Fork, WV 25920-0039

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20041129000547 WV Practitioner - Nurse Practitioner 3072578368 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0387963WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alwahido Medical Corporation M C CurrentSince Jul 10, 2019 Accepting new patients
Cherokee Emergency Services, Inc. Nurse Practitioner Past Accepting new patients
Beckley Emergency Physicians LLC Nurse Practitioner Past Accepting new patients

Locations

451 Stanaford Rd
Beckley, WV 25801
Phone (304) 256-8227

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053354969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "SLAB FORK",
            "state": "WV",
            "postal_code": "259200039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 HARPER RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013357",
            "telephone_number": "304-256-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATON",
        "first_name": "TAMMY",
        "middle_name": "F.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "0387963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.