Keshaun Necole Harding, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.021293 Issued in IL

Practice address

3742 Beech St
Flossmoor, IL 60422-1004

Phone

(708) 802-2620

Fax

(844) 230-8586

NPI assigned

Apr 28, 2020

Last updated

May 14, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evohome Medical CorporationGroup PAC ID 4486168515, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evohome Medical Corporation

  dba EvoHome Medical Group

  • General Practice Physician
  • Chicago, IL
  • NPI 1346036720
  Medicare reassignment Care Compare group
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  IL

  Medicare reassignment NPD
• Altea Medical Illinois PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago Heights, IL
  • NPI 1447039227
  Medicare reassignment

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1376164608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 BEECH ST",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221004",
            "telephone_number": "708-802-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 BEECH ST",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221004",
            "telephone_number": "708-802-2620",
            "fax_number": "844-230-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDING",
        "first_name": "KESHAUN",
        "middle_name": "NECOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021293",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041387946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Haglund, LCSW
• Charlene Hall
• Maureen Hall
• Elizabeth Kelly Hanno, O.D.
• Rachel Diane Harden-Maddox, LCPC, CADC
• Jennifer Booth Hardy, PHARM.D.
• Quiana M Hardy
• Agnes Harmon, CNS
• Farah Harris, MA, LCPC
• Iyuna Harris, MOT

• Family Nurse Practitioner in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.