Jelena McKeithan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5015978 Issued in NC

Practice address

127 S Main St
Davidson, NC 28036-8096

Phone

(704) 892-7211

NPI assigned

Feb 18, 2022

Last updated

Apr 1, 2022By 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 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Family Medicine IncGroup PAC ID 0840558342, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16389/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Family Medicine, Inc.

  • Community/Behavioral Health Agency
  • Mooresville, NC
  • NPI 1881144590
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1245985092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S MAIN ST",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368096",
            "telephone_number": "704-892-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S MAIN ST",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368096",
            "telephone_number": "704-892-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEITHAN",
        "first_name": "JELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F01220404",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer McDonald, SCD, CHES, NBC-HWC
• Margaret Nixon McFarlin, LCMHCA
• John Clark McGimsey, L.AC.
• Lijie Chu McGimsey, MAC
• Kara McHouell, ATC, LAT
• Keena S McLemore, PTA
• Allyse Ronae McNeil
• Nimisha Merchant, LCMHCA
• Michael B Wilhite DMD PA (Davidson Cosmetic and Family Dentistry)
• Milk Honey Counseling

• Family Nurse Practitioner in Davidson, NC
• Providers in Davidson, 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 Apr 1, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.