Individual provider Active NPI

Krista Lauren Keen, NP

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1124585880
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN209195 Issued in GA
Practice address
3448 Vineville Ave
Macon, GA 31204-1867
Phone
(478) 405-0045
Fax
(478) 405-0054
NPI assigned
Feb 28, 2019
Last updated
Dec 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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 RN209195 GA Primary

Addresses

Primary practice location

3448 Vineville Ave
Macon, GA 31204-1867

Mailing address

3448 Vineville Ave
Macon, GA 31204-1867
Phone (478) 405-0045

Other practice location 1

277 Perry Pkwy Ste C
Perry, GA 31069-8428
Phone (478) 988-6087

Other names 1

  • Krista Shugart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190412001959 GA Practitioner - Nurse Practitioner 0840531166 Reassigns benefits to 2 organizations
Practice locations: Perry, GA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vineville Internal Medicine LLCGroup PAC ID 0941281711, 25 clinicians

Practice addresses (Care Compare)

3448 Vineville Ave
Macon, GA 31204-1867
Phone (478) 405-0045

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnect Health, Inc. CurrentSince Mar 6, 2019 Accepting new patients
Vineville Internal Medicine LLC CurrentSince Oct 6, 2022 Accepting new patients
Careconnect Health, Inc. CurrentSince Mar 6, 2019 Accepting new patients

Locations

3448 Vineville Ave
Macon, GA 31204
Phone (478) 405-0045

277 Perry Pkwy
Ste C
Perry, GA 31069
Phone (478) 988-6087

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

506 Osigian Blvd
Ste 4
Warner Robins, GA 31088
Phone (478) 405-0045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1124585880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3448 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041867",
            "telephone_number": "478-405-0045",
            "fax_number": "478-405-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3448 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041867",
            "telephone_number": "478-405-0045",
            "fax_number": "478-405-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Perry Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "GA",
            "postal_code": "310698428",
            "country_code": "US",
            "telephone_number": "478-988-6087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEN",
        "first_name": "KRISTA",
        "middle_name": "LAUREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN209195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "SHUGART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.