La Keisha Fair, MAE, ATC,LAT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

0000001348 Issued in TN

Practice address

1 Cumberland Square
Lebanon, TN 37087

Phone

(615) 453-6327

NPI assigned

Jul 31, 2014

Sex

Female

Sole proprietor

No

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1588072771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CUMBERLAND SQ",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873408",
            "telephone_number": "615-453-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CUMBERLAND SQUARE",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-453-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "LA KEISHA",
        "credential": "MAE, ATC,LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TN",
            "license": "0000001348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Enoch, OTR/L
• Gretchen Dene Etheredge, PT
• Randolph R Evans, MD
• Donald O. Ezuteh, M.D.
• Kathy Fahner
• Family Eye Med, PLLC
• Family Medical Community Healthcare, PLLC
• Family Medical PC
• Erick Farmer
• Haleigh Farmer

• Community Health Worker in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Community Health Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.