Individual provider Active NPI

Gloria Jean Keitt I, LICENSED NURSE

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1154515799
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
241424 Issued in NY
Practice address
14 Weeger Street
Rochester, NY 14605
Phone
(585) 546-4508
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 241424 NY Primary

Addresses

Primary practice location

14 Weeger Street
Rochester, NY 14605

Mailing address

14 Weeger St
Rochester, NY 14605-1350
Phone (585) 546-4508

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

State licenses

LicenseStateTypeSpecialty
241424NYMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1154515799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WEEGER ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146051350",
            "telephone_number": "585-546-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WEEGER STREET",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14605",
            "telephone_number": "585-546-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITT",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "name_prefix": "Miss",
        "name_suffix": "I",
        "credential": "LICENSED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "241424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.