Active NPI
Keshia Juarez
- Surgical Assistant
- Carterville, IL
National Provider Identifier
1174302863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 1728 Heritage CT
Carterville, IL 62918-0024 - Phone
- (618) 967-8521
- NPI assigned
- Sep 22, 2023
- Last updated
- Sep 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | NU | Primary |
Addresses
Primary practice location
1728 Heritage CT
Carterville, IL 62918-0024
Mailing address
1728 Heritage CT
Carterville, IL 62918-0024
Phone (618) 967-8521
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": "1695340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1174302863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1728 HERITAGE CT",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629180024",
"telephone_number": "618-967-8521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1728 HERITAGE CT",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629180024",
"telephone_number": "618-967-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "KESHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-22",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carterville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.