Active NPI
Sota Keo, ANP-C
- Adult Health Nurse Practitioner
- Sun City, AZ
National Provider Identifier
1790719839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- AP1891
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| AP1891 | AZ | MD | Adult 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.