Individual provider Active NPI

Andrea Doorack Keagy, F.N.P. , R.N., PHN

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1083707319
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15545 Issued in CA
Practice address
3885 24TH St
San Francisco, CA 94114-3840
Phone
(415) 529-4522
Fax
(415) 291-0489
NPI assigned
Sep 30, 2006
Last updated
Nov 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15545 CA Primary
Registered Nurse 163W00000X 632547 CA

Addresses

Primary practice location

3885 24TH St
San Francisco, CA 94114-3840

Mailing address

130 Sutter St FL 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Other practice location 1

2000 Van Ness Ave
Suite 402
San Francisco, CA 94109-3023
Phone (650) 567-1219

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
632547CAMDRegistered Nurse
15545CAMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1083707319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 24TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941143840",
            "telephone_number": "415-529-4522",
            "fax_number": "415-291-0489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Van Ness Ave",
            "address_2": "Suite 402",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941093023",
            "country_code": "US",
            "telephone_number": "650-567-1219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEAGY",
        "first_name": "ANDREA",
        "middle_name": "DOORACK",
        "credential": "F.N.P. , R.N., PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15545",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "632547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.