Lacey Danielle Keeth, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP09734 Issued in LA

Practice address

1643 Carter Street
Suite #1
Vidalia, LA 71373

Phone

(318) 336-8707

Fax

(318) 336-8876

NPI assigned

Sep 12, 2012

Last updated

Oct 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Concordia Parish Hospital Service District Number One

  dba Trinity Medical Ferriday Clinic

  • Rural Health Clinic/Center
  • Ferriday, LA
  • NPI 1679513600
  Medicare reassignment NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical

  • Family Medicine Physician
  • Ferriday, LA
  • NPI 1952565335
  Medicare reassignment NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical

  • Critical Access Hospital
  • Ferriday, LA
  • NPI 1275852303
  NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical

  • Critical Access Hospital
  • Ferriday, LA
  • NPI 1144227935
  NPD (past)
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical Vidalia Clinic

  • Rural Health Clinic/Center
  • Vidalia, LA
  • NPI 1780190322
  NPD (past)
• Miss-Lou OB-GYN Ctr,, Inc

  • Medical Specialty Clinic/Center
  • Natchez, MS
  • NPI 1316383433
  NPD (past)

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1679823090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 CARTER STREET",
            "address_2": "SUITE #1",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "71373",
            "telephone_number": "318-336-8707",
            "fax_number": "318-336-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 CARTER STREET",
            "address_2": "SUITE #1",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "71373",
            "telephone_number": "318-336-8707",
            "fax_number": "318-336-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEETH",
        "first_name": "LACEY",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R872599",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2460561",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Condoleezzia Jones
• Contaka Jones
• Melinda Inez Jones
• Just Health
• Just Health
• Latanyle Kennedy-Smith, MS
• Jared Kerrigan
• Robert Kersh, MHP
• Michelle Kimberly, PA
• Valencia Shardai King

• Family Nurse Practitioner in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.