Keenya Anderson Staten, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5006213 Issued in NC

Practice address

1701 Sunset Ave Ste 105C
Rocky Mount, NC 27804

Phone

(252) 969-0432

Fax

(888) 977-1275

NPI assigned

May 31, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

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 and National Provider Directory roles.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  NC

  Medicare reassignment NPD
• Gods Promises of Rocky Mount, Inc

  • Public Health & General Preventive Medicine Physician
  • Rocky Mount, NC
  • NPI 1558114090
  NPD (past)
• Monique Brown, MD PC

  • General Practice Physician
  • Rocky Mount, NC
  • NPI 1740480888
  NPD (past)

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1700223609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SUNSET AVE STE 105C",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278044344",
            "telephone_number": "252-969-0432",
            "fax_number": "888-977-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SUNSET AVE STE 105C",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "27804",
            "telephone_number": "252-969-0432",
            "fax_number": "888-977-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "KEENYA",
        "middle_name": "ANDERSON",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5006213",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5006213",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Johnson Companion Services (Stacy's @ Home Health Care)
• Candice Sherese Stallworth, MSN, PMHNP-BC
• Standard Above All, Inc.
• Patricia L Stanford-Adams, OD
• Starting Pointe, Inc.
• Chantel Staton
• Jessica Cary Staton
• Lisha A Steed, AGNP
• Sterling House of Rocky Mount
• Randall Stewart, DPT

• Family Nurse Practitioner in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.