Nina Alice Keown, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0912212 Issued in GA

Practice address

4233 Camelot Crossing
Valdosta, GA 31602

Phone

(229) 469-4383

NPI assigned

Oct 11, 2012

Last updated

Oct 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thacker Dermatology LLCGroup PAC ID 0547443970, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11118/brand/5/csg/22/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thacker Dermatology LLC

  • Dermatology Physician
  • Valdosta, GA
  • NPI 1326347238
  Medicare reassignment Care Compare group NPD
• Valdosta Orthopedic Associates PC

  dba Valdosta Orthopedic Associates

  • Orthopaedic Surgery Physician
  • Valdosta, GA
  • NPI 1053457457
  NPD (past)

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1316299662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4233 CAMELOT CROSSING",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-469-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 CAMELOT CROSSING",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-469-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOWN",
        "first_name": "NINA",
        "middle_name": "ALICE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F0912212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shonette Kendrick
• Kevin Lee Kenworthy, M.D.
• Kenya R. Barnes, LMFT, LLC
• Kenya R. Barnes, LMFT, LLC (Changes of View)
• Jennifer Kenyon, LCSW
• Keystone Therapy Services
• Hitham H Khalil, M.D.
• Charmaine Kidd, FNP
• Kilby Family Dentistry, LLC
• Dustin Ross Kilby, D.M.D.

• Family Nurse Practitioner in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.