Individual provider Active NPI

Tina S Keaton, NP-C

  • Nurse Practitioner
  • Blairsville, GA
National Provider Identifier
1548686272
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN107500 Issued in GA
Practice address
308 Deep South Farm Rd
Suite 200
Blairsville, GA 30512-2218
Phone
(706) 835-2235
Fax
(706) 835-1706
NPI assigned
Mar 5, 2014
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN107500 GA Primary

Addresses

Primary practice location

308 Deep South Farm Rd
Suite 200
Blairsville, GA 30512-2218

Mailing address

1835 Savoy Dr
Suite 300
Atlanta, GA 30341-1072
Phone (706) 835-2235

Other identifiers 1

IdentifierTypeStateIssuer
003144263A,B,DMedicaidGA

Other names 1

  • Miss Shelley Keaton Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tina.keatonnp.p1@direct.gacancer.nextgenshare.com Direct
Direct Messaging Address tina.keatonnp.p1@direct.gacancer.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20140402001337 GA Practitioner - Nurse Practitioner 9931330057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

308 Deep S Farm Rd
Suite 200
Blairsville, GA 30512-2218
Phone (706) 385-2235

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN107500GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G, LLC CurrentSince Mar 1, 2014 Accepting new patients
NSH Cancer Institute Professional Services G, LLC Current Accepting new patients
NSH Cancer Institute Professional Services G LLC CurrentSince Mar 1, 2014 Accepting new patients
Northside Imaging LLC Past Accepting new patients

Locations

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

308 Deep South Farm Rd
Ste 200
Blairsville, GA 30512
Phone (706) 385-2235

101 Riverstone Vis
Ste 102
Blue Ridge, GA 30513
Phone (706) 258-4140

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

Interoperability endpoints

  • Direct secure messaging: tina.keatonnp.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1548686272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "706-835-2235",
            "fax_number": "706-835-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 DEEP SOUTH FARM RD",
            "address_2": "SUITE 200",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122218",
            "telephone_number": "706-835-2235",
            "fax_number": "706-835-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATON",
        "first_name": "TINA",
        "middle_name": "S",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-05",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN107500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144263A,B,D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tina.keatonnp.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "308 Deep South Farm Rd",
            "address_2": "Suite 200",
            "city": "Blairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305122218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tina.keatonnp.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "308 Deep South Farm Rd",
            "address_2": "Suite 200",
            "city": "Blairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305122218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "KEATON",
            "prefix": "MISS",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.