Individual provider Active NPI

Keisha Davis, RN

  • Registered Nurse
  • Freeport, NY
National Provider Identifier
1275804114
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
499498-1 Issued in NY
Practice address
181 N Long Beach Ave
Freeport, NY 11520-2102
Phone
(212) 470-4833
NPI assigned
Jan 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 499498-1 NY Primary

Addresses

Primary practice location

181 N Long Beach Ave
Freeport, NY 11520-2102

Mailing address

181 N Long Beach Ave
Freeport, NY 11520-2102
Phone (212) 470-4833

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
499498-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1275804114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 N LONG BEACH AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202102",
            "telephone_number": "212-470-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 N LONG BEACH AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115202102",
            "telephone_number": "212-470-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEISHA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "499498-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.