Jacqueline Kelly Keith, MSN, RN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

141062 Issued in NC

Practice address

130 Carbonton Rd
Sanford, NC 27330-4009

Phone

(919) 774-6521

Fax

(919) 776-6179

NPI assigned

Mar 27, 2018

Last updated

Mar 27, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: jacqueline.keith.p1@direct.daymarkrecovery.nextgenshare.com

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1326543877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 SADDLEBROOK DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273309174",
            "telephone_number": "919-721-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CARBONTON RD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304009",
            "telephone_number": "919-774-6521",
            "fax_number": "919-776-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "JACQUELINE",
        "middle_name": "KELLY",
        "credential": "MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NC",
            "license": "141062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen S Romine DDS PA
• Katherine H. Johnson OD (Central Carolina Optometry)
• Shivani Bashiyan Kaushik, M.D.
• Salita Keen, BCBA
• Cary Keifer, M.D.
• Kellers Nursing Home Inc (Kellers Oakhaven Retirement Home)
• Kellers Nursing Home Inc (Kellers Oakhaven Retirement Home)
• Kellers Nursing Home Inc (Kellers Oakhaven Retirement Home)
• Rita Helen Kelly, CNM
• Ginger Ann Kenney, PA-C

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Sanford, NC
• Providers in Sanford, NC by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.