Mara E Keith, AGNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5007439 Issued in NC

Practice address

8401 Medical Plaza Dr
Ste 365
Charlotte, NC 28262-8797

Phone

(704) 944-0975

Fax

(704) 943-3699

NPI assigned

Jan 22, 2015

Last updated

Feb 3, 2016By the provider in NPPES

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

• Mara E Lindberg Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1184013534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 MEDICAL PLAZA DR",
            "address_2": "STE 365",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628797",
            "telephone_number": "704-944-0975",
            "fax_number": "704-943-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MEDICAL PLAZA DR",
            "address_2": "STE 365",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628797",
            "telephone_number": "704-944-0975",
            "fax_number": "704-943-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "MARA",
        "middle_name": "E",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "LINDBERG",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keith Clinic Estramonte Chiropractic
• Keith Clinic of Chiropractic, P.a.
• Keith Wellness & Rehabilitation Center, P.a.
• Ava Claire Keith, DPT
• Gracee Keith
• Nadirah Nafeesah Keith, DNP, FNP-C, PMHNP-BC
• Spurgeon Keith III, MD
• Sydney Lametta Keith, MSW, LCSWA
• Emily Paige Keller, PA-C
• Jennifer Lynn Keller, PHARMD

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.