Individual provider Active NPI

Keshia Edwards, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1689487795
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704226239 Issued in MI
Practice address
10201 E Jefferson Ave
Detroit, MI 48214-3149
Phone
(313) 446-8980
NPI assigned
Jan 31, 2025
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704226239 MI Primary

Addresses

Primary practice location

10201 E Jefferson Ave
Detroit, MI 48214-3149

Mailing address

10201 E Jefferson Ave
Detroit, MI 48214-3149
Phone (313) 446-8980

Other practice location 1

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260127002229 MI Practitioner - Nurse Practitioner 1951888437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

290 Town Ctr Dr
Suite 400
Dearborn, MI 48126

290 Town Ctr Dr
Suite 400
Dearborn, MI 48126-2765

PO Box
Suite 8574
Elkridge, MD 21075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704226239MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Backpack Medical Group, P.C. Psychiatric/Mental Health CurrentSince Jan 5, 2026 Accepting new patients
Linnel Inc Psychiatric/Mental Health PastSince Sep 5, 2023 Accepting new patients

Locations

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1689487795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143149",
            "telephone_number": "313-446-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143149",
            "telephone_number": "313-446-8980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KESHIA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704226239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.