Keanu Jomelle Juani Gomez, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4025567 Issued in KY

Practice address

3101 Beaumont Centre Cir Ste 100
Lexington, KY 40513-1959

Phone

(859) 323-5544

Fax

(859) 257-9286

NPI assigned

Jul 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Medicare enrollment (NPD)

Enrolled

Credentials

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 and National Provider Directory roles.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment Care Compare group NPD
• University of Kentucky

  • Psychiatric Hospital Unit
  • Lexington, KY
  • NPI 1821130741
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Kentucky

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1518911338
  Care Compare affiliation

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1740026137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BEAUMONT CENTRE CIR STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BEAUMONT CENTRE CIR STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131959",
            "telephone_number": "859-323-5544",
            "fax_number": "859-257-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "KEANU JOMELLE",
        "middle_name": "JUANI",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1167714",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4025567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Ashley Golibersuch, D.M.D,
• Ryan J Golibersuch, D.M.D.
• Chastity Golphin
• Saritha R Gomadam, D.O
• Gabriel Gomez, PSYD
• Lauren Gomez
• Maria Del Carmen Gomez
• Robby-Roy S Gomez
• Amlish Bilal Gondal, MD
• Morgan Alleabelle Gongola

• Family Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.