Individual provider Active NPI

Joan Marie Keeter, RN, BSN

  • Psychiatric/Mental Health Registered Nurse
  • Fort Gratiot, MI
National Provider Identifier
1427160589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
4704121411 Issued in MI
Practice address
3847 Pine Grove Ave
Suite a
Fort Gratiot, MI 48059-4265
Phone
(810) 966-3727
Fax
(810) 985-7350
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704121411 MI Primary

Addresses

Primary practice location

3847 Pine Grove Ave
Suite a
Fort Gratiot, MI 48059-4265

Mailing address

3847 Pine Grove Ave
Suite a
Fort Gratiot, MI 48059-4265
Phone (810) 966-3727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704121411MIMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427160589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3847 PINE GROVE AVE",
            "address_2": "SUITE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594265",
            "telephone_number": "810-966-3727",
            "fax_number": "810-985-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3847 PINE GROVE AVE",
            "address_2": "SUITE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594265",
            "telephone_number": "810-966-3727",
            "fax_number": "810-985-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETER",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704121411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.