Active NPI
Keshia Ricamona, CST
- Surgical Technologist
- Henderson, NV
National Provider Identifier
1235521709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 152172
- Practice address
- 10561 Jeffreys St
Ste 230
Henderson, NV 89052-4266 - Phone
- (702) 565-6565
- Fax
- (702) 990-5255
- NPI assigned
- Feb 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 Technologist | 246ZS0410X | 152172 | NV | Primary |
Addresses
Primary practice location
10561 Jeffreys St
Ste 230
Henderson, NV 89052-4266
Mailing address
10561 Jeffreys St
Ste 230
Henderson, NV 89052-4266
Phone (702) 565-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 152172 | Other | NV | NBSTSA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152172 | NV | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1235521709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10561 JEFFREYS ST",
"address_2": "STE 230",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890524266",
"telephone_number": "702-565-6565",
"fax_number": "702-990-5255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10561 JEFFREYS ST",
"address_2": "STE 230",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890524266",
"telephone_number": "702-565-6565",
"fax_number": "702-990-5255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICAMONA",
"first_name": "KESHIA",
"credential": "CST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-20",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "NV",
"license": "152172",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBSTSA",
"identifier": "152172",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.