Individual provider Active NPI

Ayesha Khalilah Keddo, APRN

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1407547987
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11025112 Issued in FL
Practice address
350 7TH St N
Naples, FL 34102-5754
Phone
(239) 624-5000
Fax
(239) 624-8101
NPI assigned
May 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11025112 FL Primary

Addresses

Primary practice location

350 7TH St N
Naples, FL 34102-5754

Mailing address

350 7TH St N
Naples, FL 34102-5754
Phone (239) 624-8105

Other names 1

  • Ayesha Khalilah Ferguson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20230712003957 FL Practitioner - Nurse Practitioner 6608236385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

350 7TH St N
Naples Community Hospital
Naples, FL 34102-5754
Phone (239) 436-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd Inc CurrentSince Jun 29, 2023 Accepting new patients
Nchmd, Inc CurrentSince Jun 29, 2023 Accepting new patients

Locations

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: akeddo63332@nchhealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1407547987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 7TH ST N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025754",
            "telephone_number": "239-624-8105",
            "fax_number": "239-624-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 7TH ST N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025754",
            "telephone_number": "239-624-5000",
            "fax_number": "239-624-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDDO",
        "first_name": "AYESHA",
        "middle_name": "KHALILAH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11025112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYESHA",
            "last_name": "FERGUSON",
            "middle_name": "KHALILAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.