Individual provider Active NPI

Greta Louise Keys, FNP-BC

  • Family Nurse Practitioner
  • Brookhaven, MS
National Provider Identifier
1497762256
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R843927 Issued in MS
Practice address
332 E Monticello St
Brookhaven, MS 39601-3430
Phone
(601) 833-3500
Fax
(601) 292-6384
NPI assigned
Aug 2, 2006
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Family Nurse Practitioner 363LF0000X R843927 MS Primary

Addresses

Primary practice location

332 E Monticello St
Brookhaven, MS 39601-3430

Mailing address

332 E Monticello St
Brookhaven, MS 39601-3430
Phone (601) 833-3500

Other identifiers 3

IdentifierTypeStateIssuer
P00823061OtherMSRAILROAD MEDICARE
2014619OtherMSCIGNA
04187246MedicaidMS

Other names 1

  • Ms. Greta L Williams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20041013000566 MS Practitioner - Nurse Practitioner 5395705461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 Spring Hill Rd
Silver Creek, MS 39663-5200
Phone (601) 833-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R843927MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Healthkey Clinic, LLC Primary Care CurrentSince Jul 1, 2011 Accepting new patients
Bonita C. Musial Past Accepting new patients
Gulfport Emergency Physicians Past Accepting new patients

Locations

332 E Monticello St
Brookhaven, MS 39601
Phone (601) 669-7357

55 Spring Hill Rd
Silver Creek, MS 39663
Phone (601) 833-3500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1497762256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E MONTICELLO ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013430",
            "telephone_number": "601-833-3500",
            "fax_number": "601-292-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 E MONTICELLO ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013430",
            "telephone_number": "601-833-3500",
            "fax_number": "601-292-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYS",
        "first_name": "GRETA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R843927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00823061",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2014619",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04187246",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRETA",
            "last_name": "WILLIAMS",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookhaven, MS

Sources for this page

Verify at the official NPI Registry.