Individual provider Active NPI

Keyona Darje' Jeter, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1619633559
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F348604 Issued in NY
Practice address
241 W 57TH St
New York, NY 10019-2121
Phone
(212) 547-5848
NPI assigned
Nov 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 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 F348604 NY Primary

Addresses

Primary practice location

241 W 57TH St
New York, NY 10019-2121

Mailing address

241 W 57TH St
New York, NY 10019-2121
Phone (212) 247-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F348604NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Medical Care PC CurrentSince May 17, 2023 Accepting new patients

Locations

17811 Union Tpke
Fresh Meadows, NY 11366
Phone (516) 729-7282

177 Dyckman St
New York, NY 10040
Phone (212) 544-0023

175 Route 59
Spring Valley, NY 10977
Phone (845) 352-6800

Interoperability endpoints

  • Direct secure messaging: keyona.jeter.1@14883.direct.athenahealth.com
  • Direct secure messaging: keyona.sanders.1@24989.direct.athenahealth.com

Organizations & group practices 1

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": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1619633559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192121",
            "telephone_number": "212-247-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192121",
            "telephone_number": "212-547-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "KEYONA",
        "middle_name": "DARJE'",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F348604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.