Keisha Witherspoon

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP132272 Issued in TX

Practice address

610 Uptown Blvd Ste 2000
Cedar Hill, TX 75104-3528

Phone

(972) 716-2969

Fax

(214) 594-8747

NPI assigned

Oct 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• Witherspoon Mental Health and Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cedar Hill, TX
  • NPI 1447809983
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1164974986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 UPTOWN BLVD STE 2000",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043528",
            "telephone_number": "972-716-2969",
            "fax_number": "214-594-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 UPTOWN BLVD STE 2000",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043528",
            "telephone_number": "972-716-2969",
            "fax_number": "214-594-8747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "182 SW Academy St Ste 333",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "OR",
            "postal_code": "973381996",
            "country_code": "US",
            "telephone_number": "503-623-9289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "KEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132272",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201902386NP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "743838",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP132272",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ericka Danay Wilson
• Fayetta Renee Wilson
• Awhawanna Wenona Wise
• Michael Wistrom, DDS
• Witherspoon Mental Health and Wellness, PLLC
• Erica Wood, CCC-SLP
• Woodus Obstetrics and Gynecology, PLLC
• Kenneth Yang, PT, DPT
• Yaw Safo M.D. PA
• Young Ladies of Integrity & Virtue Inc. (Yliv)

• Psychiatric/Mental Health Nurse Practitioner in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.