Keiontae Eason

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN295202 Issued in GA

Practice address

940 Ga Highway 96 Ste C
Warner Robins, GA 31088-2585

Phone

(478) 988-7100

Fax

(478) 988-6847

NPI assigned

Feb 18, 2022

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1467107318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 GA HIGHWAY 96",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882584",
            "telephone_number": "478-988-7100",
            "fax_number": "478-988-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 GA HIGHWAY 96 STE C",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882585",
            "telephone_number": "478-988-7100",
            "fax_number": "478-988-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASON",
        "first_name": "KEIONTAE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "RN295202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Interventions Inc
• Tracy Dyson
• E. Carl Shaw, DMD, PC
• E&K Medical LLC
• Jeffrey Charles Easom, D.O.
• Margaret Taylor Eason
• Mark Anthony Eastman Moore
• Yos'Setta Elizabeth Allean Eatmon, REGISTERED NURSE
• Jeremy Clarke Eaton, PT, MS, BS
• Tabatha C Eaton, PT, DPT

• Adult Psychiatric/Mental Health Registered Nurse in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.