Individual provider Active NPI

Bridgette Leigh Keene, FNP

  • Family Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1659921369
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024177878 Issued in VA
Practice address
1234 Franklin Rd SW
Roanoke, VA 24016-4606
Phone
(540) 525-3585
NPI assigned
Sep 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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 0024177878 VA Primary

Addresses

Primary practice location

1234 Franklin Rd SW
Roanoke, VA 24016-4606

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5715

Other practice location 1

5372 Fallowater Ln
Roanoke, VA 24018-0907
Phone (540) 525-3585

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
I20200304002775 VA Practitioner - Nurse Practitioner 3870920788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

5372 Fallowater LN
Roanoke, VA 24018-0907
Phone (540) 283-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024177878VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Dec 18, 2022 Accepting new patients
Carilion Medical Center CurrentSince Dec 18, 2022 Accepting new patients

Locations

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

5372 Fallowater Ln
Roanoke, VA 24018
Phone (540) 283-6000

1234 Franklin Rd SW
Roanoke, VA 24016
Phone (540) 283-6000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Interoperability endpoints

  • Direct secure messaging: bkeene98746@direct.carilionclinic.org

Organizations & group practices 2

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.

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": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1659921369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164606",
            "telephone_number": "540-525-3585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5372 Fallowater Ln",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240180907",
            "country_code": "US",
            "telephone_number": "540-525-3585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENE",
        "first_name": "BRIDGETTE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-14",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.