Carolina Mona Keene, DNP-AGACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

201801773NP-PP Issued in OR

Practice address

4940 Hamrick Rd
Medford, OR 97502-3072

Phone

(541) 535-6239

NPI assigned

Nov 28, 2017

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

Medicare fee-for-service enrollment

Enrolled in OR

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.

• La Clinica del Valle Family Health Care Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1851327571
  Medicare reassignment NPD

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1255845319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 HAMRICK RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975023072",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONA KEENE",
        "first_name": "CAROLINA",
        "credential": "DNP-AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201801773NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Moissant
• Azusa Mokuta
• Jeremy Molck
• Kendra Mollette, CBS
• George W Molzen, MD
• Chedric Robert Monahan, LCSW
• Jose M Mondesi-Garrido, MD
• Jennifer Mondesi, PH.D.
• Julie Ann Mondz-Kleinman
• Martin Taylor Monnett

• Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.