Individual provider Active NPI

Roberta Jan Keegan, ARNP, FNP

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1093786576
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0021928 Issued in OK
Practice address
6655 S Yale Ave
Laureate Psychiatric Clinic and Hospital
Tulsa, OK 74136-3326
Phone
(918) 491-5681
Fax
(918) 491-5740
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0021928 OK Primary

Addresses

Primary practice location

6655 S Yale Ave
Laureate Psychiatric Clinic and Hospital
Tulsa, OK 74136-3326

Mailing address

PO Box 21228
Department 31
Tulsa, OK 74121-1228
Phone (918) 491-5681

Other identifiers 2

IdentifierTypeStateIssuer
2048484OtherCIGNA BEHAVIORAL HEALTH
100128890AMedicaidOK

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

State licenses

LicenseStateTypeSpecialty
21928OKMDClinical Social Worker
R0021928OKMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: roberta.keegan.1@23846.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1093786576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21228",
            "address_2": "DEPARTMENT 31",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741211228",
            "telephone_number": "918-491-5681",
            "fax_number": "918-491-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 S YALE AVE",
            "address_2": "LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363326",
            "telephone_number": "918-491-5681",
            "fax_number": "918-491-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEGAN",
        "first_name": "ROBERTA",
        "middle_name": "JAN",
        "name_prefix": "Mrs.",
        "credential": "ARNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0021928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2048484",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100128890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.