Individual provider Active NPI

Lakeisha Keneti, DNP,FNP-C, PMH-BC

  • Family Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1609119452
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024170662 Issued in VA
Practice address
2470 Pruden Blvd
Suffolk, VA 23434-4206
Phone
(757) 922-8046
Fax
(757) 922-8049
NPI assigned
Mar 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024170662 VA Primary

Addresses

Primary practice location

2470 Pruden Blvd
Suffolk, VA 23434-4206

Mailing address

2470 Pruden Blvd
Suffolk, VA 23434-4206
Phone (757) 922-8048

Other practice location 1

2470 Pruden Blvd
Suffolk, VA 23434-4206
Phone (757) 922-8048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20140314000393 VA Practitioner - Nurse Practitioner 7214168202 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Therapeutic Solutions CurrentSince Jun 1, 2024 Accepting new patients
Charis Mental Health, PLLC Family CurrentSince Jun 1, 2017 Accepting new patients
Charis Mental Health Plus Integrative Care Current Accepting new patients
Parker Schlichter & Associates Past Accepting new patients

Locations

355 Crawford St
Ste 102
Portsmouth, VA 23704
Phone (757) 232-3321

2470 Pruden Blvd
Suffolk, VA 23434
Phone (757) 922-8046

Interoperability endpoints

  • Direct secure messaging: lakeisha.keneti@4096.securemail.prognocis.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1609119452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 PRUDEN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344206",
            "telephone_number": "757-922-8048",
            "fax_number": "757-922-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 PRUDEN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344206",
            "telephone_number": "757-922-8046",
            "fax_number": "757-922-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2470 Pruden Blvd",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234344206",
            "country_code": "US",
            "telephone_number": "757-922-8048",
            "fax_number": "757-922-8049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENETI",
        "first_name": "LAKEISHA",
        "name_prefix": "Dr.",
        "credential": "DNP,FNP-C, PMH-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-30",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024170662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.