Individual provider Active NPI

Keisha Desgouttes

  • Other Technician
  • Cleveland HTS, OH
National Provider Identifier
1164239059
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
3579 Atherstone Rd
Cleveland HTS, OH 44121-1355
Phone
(754) 201-7180
NPI assigned
Dec 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X OH Primary

Addresses

Primary practice location

3579 Atherstone Rd
Cleveland HTS, OH 44121-1355

Mailing address

3579 Atherstone Rd
Cleveland HTS, OH 44121-1355
Phone (754) 201-7180

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

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1164239059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3579 ATHERSTONE RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441211355",
            "telephone_number": "754-201-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3579 ATHERSTONE RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441211355",
            "telephone_number": "754-201-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESGOUTTES",
        "first_name": "KEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.