Individual provider Active NPI

Sota Keo, ANP-C

  • Adult Health Nurse Practitioner
  • Sun City, AZ
National Provider Identifier
1790719839
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP1891 Issued in AZ
Practice address
10147 Grand Ave
Sun City, AZ 85351-3435
Phone
(602) 222-2631
Fax
(602) 222-2633
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP1891 AZ Primary

Addresses

Primary practice location

10147 Grand Ave
Sun City, AZ 85351-3435

Mailing address

15147 W Cortez St
Surprise, AZ 85379-5236
Phone (623) 217-3318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP1891AZMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790719839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15147 W CORTEZ ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795236",
            "telephone_number": "623-217-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10147 GRAND AVE",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513435",
            "telephone_number": "602-222-2631",
            "fax_number": "602-222-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEO",
        "first_name": "SOTA",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP1891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.