Alissa R Keysor, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

164075 Issued in OH

Practice address

475 Lexington Ave
Mansfield, OH 44907-1501

Phone

(419) 419-5705

NPI assigned

Apr 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ohio Treatment Center, LLC

  • Methadone Clinic
  • Massillon, OH
  • NPI 1295233054
  NPD (past)

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1164041125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 PLYMOUTH ST APT A",
            "city": "PLYMOUTH",
            "state": "OH",
            "postal_code": "448651027",
            "telephone_number": "419-515-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071501",
            "telephone_number": "419-419-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYSOR",
        "first_name": "ALISSA",
        "middle_name": "R",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "164075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alissa.keysor@ctcprograms.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Work email",
            "address_1": "475 Lexington Ave",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449071501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter Michael Kenyon, CDCA
• Jill W Kerbs, DDS
• Chad Kernell
• Cody Michael Kessler
• Kim Keyes, RN, BSN
• Keystone Richland Center LLC
• Keystone Richland Center, LLC
• Jamila K Khan, DO
• Shahzad M Khan, M.D.
• Kidney Associates, Inc.

• Licensed Practical Nurse in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; 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.