Mara S Kevan, DACM, L.AC., DIPL.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

4079 Issued in FL

Practice address

111 2ND Ave NE Ste 705
St Petersburg, FL 33701-3441

Phone

(727) 677-8006

NPI assigned

May 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Mara S Kevan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1457611477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 4TH ST N # 195",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337012322",
            "telephone_number": "727-677-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE STE 705",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013441",
            "telephone_number": "727-677-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEVAN",
        "first_name": "MARA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DACM, L.AC., DIPL.AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC158039",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "4079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "KEVAN",
            "middle_name": "S",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katarina Rose Kesty, M.D.
• Kenneth Richard Kesty
• Alexandria Victoria Ketchersid, LCSW
• Carmen Ketchum-Lugo
• Ravi Reddy Kethireddy, MD
• Key Counseling and Supervision
• Amanda L Keys, PTA
• Keystone Home Health, Inc.
• Younis Khair Al Deen, MD
• Anas Anis Khalaf, DC

• Acupuncturist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.