Individual provider Active NPI

Keasha Hannah, NURSING ASSISTANT

  • Personal Care Attendant
  • Baltimore, MD
National Provider Identifier
1083246854
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
4139 W Forest Park Ave FL 1
Baltimore, MD 21207-7408
Phone
(443) 410-9544
NPI assigned
Feb 10, 2020
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X MD
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X MD Primary

Addresses

Primary practice location

4139 W Forest Park Ave FL 1
Baltimore, MD 21207-7408

Mailing address

4139 W Forest Park Ave FL 1
Baltimore, MD 21207-7408
Phone (443) 410-9544

Other practice location 1

4139 W Forest Park Ave Fl 1
Baltimore, MD 21207-7408

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

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1083246854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139 W FOREST PARK AVE FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077408",
            "telephone_number": "443-410-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 W FOREST PARK AVE FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077408",
            "telephone_number": "443-410-9544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4139 W Forest Park Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212077408",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "KEASHA",
        "credential": "NURSING ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.