Keni O. Jegede, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014177 Issued in IL

Practice address

1802 Saturn Blvd
San Diego, CA 92154-4101

Phone

(619) 628-2924

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjegede@loyalsource.com

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.

• Olson Chiropractic, Inc.

  • Chiropractor
  • Aurora, IL
  • NPI 1932292992
  NPD
• Rehab and Health, LLC

  • Physical Medicine & Rehabilitation Physician
  • Hinsdale, IL
  • NPI 1679093736
  NPD (past)

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1992153860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21135 S MEADOWVIEW LN",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604048368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 SATURN BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544101",
            "telephone_number": "619-628-2924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12612 Challenger Pkwy Ste 365",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328262784",
            "country_code": "US",
            "telephone_number": "407-306-8441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21135 S Meadowview Ln",
            "address_purpose": "LOCATION",
            "city": "Shorewood",
            "state": "IL",
            "postal_code": "604048368",
            "country_code": "US",
            "telephone_number": "630-337-8674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEGEDE",
        "first_name": "KENI",
        "middle_name": "O.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kjegede@loyalsource.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1802 Saturn Blvd",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921544101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janette Jeffries-Nealy
• Ashley Nicole Jeffries
• Mason Thaine Trenton Jeffries, SFIDC
• Jeffry a Mullvain MD Inc
• Jeffry S Hays DC a Chiropractic Corporation
• Amreen Anam Jehtara, MS
• Abdisamia Jeilani
• Safia A Jeilani, MSW
• Cassandra Jella, IMF
• Steven H Jella, MA MFT

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.