Kenesha Shashana Ricketts

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11027169 Issued in FL

Practice address

16401 Northwest 37TH Ave
Miami Gardens, FL 33054

Phone

(954) 391-0036

NPI assigned

Jul 10, 2023

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 FL

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

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Mindful Medical and Health Services LLC

  • Mental Health Counselor
  • Port St Lucie, FL
  • NPI 1720759954
  Medicare reassignment NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1285312157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 N HIATUS RD UNIT 451432",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333458472",
            "telephone_number": "954-391-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16401 NORTHWEST 37TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "33054",
            "telephone_number": "954-391-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "KENESHA",
        "middle_name": "SHASHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11027169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RHP Medical Services Corp
• Dorys Barbara Ricardo Abellon
• Dairon Rafael Ricardo Martinez
• Madelin Ricardo
• Jeffry Richard
• Ride With US Transportation Corp
• Right Words Therapy Inc
• Dehja Riley
• Hulda Pierre Rinchere
• Carol Alessandra Rios Soto

• Psychiatric/Mental Health Nurse Practitioner in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.