Coretta D. Keith, DNP, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN124581 Issued in GA

Practice address

901 18TH St E
Tifton, GA 31794-3648

Phone

(229) 382-7120

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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.

• Fort Oglethorpe Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Blue Ridge, GA
  • NPI 1174024376
  Medicare reassignment NPD
• Georgia Em-I Medical Services. LLC

  • Nurse Practitioner
  • Bremen, GA
  • NPI 1851569560
  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Phoebe Putney Memorial Hospital Inc

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Medicare reassignment NPD
• Phoebe Sumter Medical Center, Inc.

  • General Acute Care Hospital
  • Americus, GA
  • NPI 1609001312
  Medicare reassignment NPD
• Dr. Coretta D. Gervin Healthcare

  • Home Health Registered Nurse
  • Albany, GA
  • NPI 1467091629

  Nurse Practitioner

  NPD Authorized official
• Georgia Em-I Medical Services PC

  • Physician Assistant
  • Chatsworth, GA
  • NPI 1699113357

  Nurse Practitioner

  NPD
• Georgia Em-I Medical Services, LLC

  • Nurse Practitioner
  • Covington, GA
  • NPI 1255213005
  NPD
• Phoebe Putney Memorial Hospital Inc

  • Community/Retail Pharmacy
  • Albany, GA
  • NPI 1891315420
  NPD
• Phoebe Sumter Medical Center, Inc

  • Rural Health Clinic/Center
  • Ellaville, GA
  • NPI 1376778001
  NPD
• Tift Regional Health System Inc

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Tift Regional Health System Inc.

  • General Acute Care Hospital
  • Tifton, GA
  • NPI 1962462226
  NPD

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1306884374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BEOWULF LN",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635831",
            "telephone_number": "404-710-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "CORETTA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4450",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN124581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00266428",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000927198E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry Jordan, CRNA
• Rhonda Jordan, SLP
• Sarah L Jordan, NP
• Geri E Justice, MD
• Anna Nicole Keen, LDO
• Jade Yvonne Kelly, M.ED, CCC-SLP
• Tiffany Kennedy
• Naeem Khan, M.D.
• Kasey Ann Kight, OTR/L
• Carley Tomlinson Kinard, M.ED., CCC-SLP

• Nurse Practitioner in Tifton, GA
• Providers in Tifton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.