Ann M Keenan, AGNP, CCRN
Individual provider Active NPI Nurse Practitioner · Dededo, GU
NPI 1669211405 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1669211405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 100208 (GU)
- Practice address
- 655 Harmon Loop Rd Ste 102
Dededo, GU 96929-6544 - Phone
- (671) 989-6600
- Fax
- (671) 989-8836
- NPI assigned
- May 21, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Rochester School of Medicine and Dentistry, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Gurusamy Inc
Practice addresses (Care Compare)
655 Harmon Loop Rd
Suite 102
Dededo, GU 96929-6544
Phone (671) 647-5355
Hospital & facility affiliations
- Health Services of the Pacific - Home Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GU
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240701001810 | GU | Practitioner - Nurse Practitioner | 6204370331 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gurusamy Inc. | Current |
Accepting new patients |
Locations
655 Harmon Loop Rd
Ste 102
Dededo, GU 96929
Phone (671) 727-8811
655 Harmon Loop Rd
Ste 300
Dededo, GU 96929
Phone (671) 989-6600
809 Chalan Pasaheru
Unit 2
Tamuning, GU 96913
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 100208 | GU | Yes |
Addresses
Primary practice location
655 Harmon Loop Rd Ste 102
Dededo, GU 96929-6544
Mailing address
809 Chalan Pasaheru Unit 2
Tamuning, GU 96913-4132
Phone (671) 647-5355
Other names
- Ms. Ann Dahlkemper
Other providers in Dededo, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.