Individual provider Active NPI

Kim Ann Keosian, ANP

  • Adult Health Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1821172412
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R139758 Issued in MD
Practice address
106 Milford St
Suite605
Salisbury, MD 21804-6953
Phone
(410) 334-2227
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 R139758 MD Primary

Addresses

Primary practice location

106 Milford St
Suite605
Salisbury, MD 21804-6953

Mailing address

106 Milford St
Suite605
Salisbury, MD 21804-6953
Phone (410) 334-2227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20140528002032 MD Practitioner - Nurse Practitioner 5193948735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
74.47
Promoting interoperability
92
Improvement activities
40
Cost
75.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R139758MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Peninsula Regional, Inc. Current Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Sep 1, 2020 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Delmarva Endoscopy Center LLC CurrentSince Oct 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

314 Franklin Ave
Ste 301
Berlin, MD 21811
Phone (410) 513-4046

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

106 Milford St
Ste 605
Salisbury, MD 21804
Phone (410) 334-2227

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821172412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE605",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-334-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE605",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-334-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOSIAN",
        "first_name": "KIM",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R139758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.