Keisha D Pugh, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN9194377 Issued in FL

Practice address

800 Prudential Dr Ste 1100
Jacksonville, FL 32207-8202

Phone

(904) 388-6518

Fax

(904) 384-1005

NPI assigned

Nov 20, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Keisha Pittman Former name

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20909/brand/1/csg/1/fhir/r4

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.

• Baptist Neurology Inc

  • Neurology Physician
  • Jacksonville, FL
  • NPI 1598995599
  NPD (past)
• Lyerly Baptist Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1740515006
  NPD (past)
• Pointe Med Pharmacy, Inc.

  • Compounding Pharmacy
  • Orange Park, FL
  • NPI 1366597015
  NPD (past)
• Pointe Medical Services Inc

  • Preferred Provider Organization
  • Orange Park, FL
  • NPI 1992844351
  NPD (past)

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1699003137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR FL B11",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR STE 1100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Monument Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322252520",
            "country_code": "US",
            "telephone_number": "904-642-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "KEISHA",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9194377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEISHA",
            "last_name": "PITTMAN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Enya Fernandez Pudpud
• Romelia Puel, RPH
• Nesert Ellaine Puenary, ASSOCIATE IN SCIENCE
• Eric Charles Puestow, MD
• Ideal Pugh
• Keith K Pugh, RPSGT
• Kena Latrelle Pugh, BS
• Regla Rosario Puig Carrillo, PMHNP-BC
• William G. Pujadas, M.D.
• George Pujalte, MD

• Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.