Individual provider Active NPI

Keisha McKinsey

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1154772499
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP131334 Issued in TX
Practice address
315 S Hampton Rd
Dallas, TX 75208-5618
Phone
(469) 800-8810
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

State licenses

LicenseStateTypeSpecialty
AP131334TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Gynecology LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

1311 Ferris Ave
Ste A
Waxahachie, TX 75165
Phone (214) 903-8070

Interoperability endpoints

  • Direct secure messaging: keisha.mckinsey.1@14883.direct.athenahealth.com
  • Direct secure messaging: keisha.mckinsey@237407481626628.direct.elationemr.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP131334 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

315 S Hampton Rd
Dallas, TX 75208-5618

Mailing address

1311 Ferris Avenue
Suite a
Waxahachie, TX 75165
Phone (214) 903-8070

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 15, 2018.

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1154772499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 FERRIS AVENUE",
            "address_2": "SUITE A",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "75165",
            "telephone_number": "214-903-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S HAMPTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085618",
            "telephone_number": "469-800-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINSEY",
        "first_name": "KEISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP131334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.