Kenyatta Denise Anderson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

024369 Issued in OH

Practice address

12914 Broadway Ave
Garfield Heights, OH 44125-1859

Phone

(216) 848-9123

Fax

(216) 848-9123

NPI assigned

Nov 7, 2017

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

Other names 1

• Kenyatta Devise Vance-Anderson Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Smart Quest Healthcare, LLC

  • Internal Medicine Physician
  • Parma, OH
  • NPI 1033708110
  Medicare reassignment
• Smart Choice Home Healthcare Services

  • Home Health Agency
  • Garfield Heights, OH
  • NPI 1548761323
  NPD
• Smart Quest Healthcare LLC

  • Health Service Clinic/Center
  • Parma, OH
  • NPI 1982290193
  NPD

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1164935599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5357 BROADVIEW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441341607",
            "telephone_number": "440-263-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12914 BROADWAY AVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441251859",
            "telephone_number": "216-848-9123",
            "fax_number": "216-848-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KENYATTA",
        "middle_name": "DENISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "024369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENYATTA",
            "last_name": "VANCE-ANDERSON",
            "middle_name": "DEVISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria R Alonso, MD
• Alpha Alliance Care LLC
• Sumayyah Salem O Altariqi
• Frank P Alvarez
• Kelly Renee Anderson, PA-C
• Blake Andonian
• Angel Dental Care
• Karen Angiulo
• Michael Herman Anikeev, M.D.
• Mehrunissa Kaiser Anis, MD

• Family Nurse Practitioner in Garfield Heights, OH
• Providers in Garfield Heights, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.