Keondra V Burch

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

797 Teague TRL Apt 13207
Lady Lake, FL 32159-3152

Phone

(352) 602-5541

NPI assigned

Nov 5, 2017

Last updated

Nov 5, 2017By the provider in NPPES

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

Other names 1

• Keondra V Allen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Divinely Chosen Services

  • In Home Supportive Care Agency
  • Lady Lake, FL
  • NPI 1417457607
  NPD Authorized official

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509840000000",
    "number": "1578075180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 TEAGUE TRL APT 13207",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593152",
            "telephone_number": "352-602-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 TEAGUE TRL APT 13207",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593152",
            "telephone_number": "352-602-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "KEONDRA",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-05",
        "last_updated": "2017-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEONDRA",
            "last_name": "ALLEN",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tara Lynne Briggs
• Keri Kristin Brooks, RPT
• Jenna Elizabeth Brown, ARNP
• Patricia Ann Brown
• Melissa Buchkovich, APRN
• Burke Collins Therapy, Inc (H2 Health)
• John Daniel Burress, DO
• Caroline Butler, PA
• Jane Zhan Cai, M.D.
• Jessica Calabro

• In Home Supportive Care Agency in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2017; 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.