Active NPI
Keisha Hooten
- Licensed Practical Nurse
- Dix Hills, NY
National Provider Identifier
1306093810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 254202
- Practice address
- 290 Concord St
Dix Hills, NY 11746-6830 - Phone
- (631) 865-0261
- NPI assigned
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 254202 | NY | Primary |
Addresses
Primary practice location
290 Concord St
Dix Hills, NY 11746-6830
Mailing address
290 Concord St
Dix Hills, NY 11746-6830
Phone (631) 865-0261
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01953617 | Medicaid | NY |
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 |
|---|---|---|---|
| 254202 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1306093810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 CONCORD ST",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117466830",
"telephone_number": "631-865-0261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 CONCORD ST",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117466830",
"telephone_number": "631-865-0261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOTEN",
"first_name": "KEISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "254202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01953617",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dix Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.