JACOB KEATON (NPI# 1164048229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164048229 |
| Entity Type | Individual |
| Full Name | JACOB KEATON |
| Practice Address |
348 Northridge Dr Lewisburg WV 24901-0010 |
| Mailing Address |
962 Coffman Cemetery Rd Lewisburg WV 24901-5629 |
| Practice Telephone | 3046613825 |
| Mailing Telephone | 3046613825 |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
164W00000X | WV | Nursing Service Providers |
| N | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers | ||
| N | 106E00000X | Assistant Behavior Analyst | Behavioral Health & Social Service Providers |
| Street Address |
348 NORTHRIDGE DR |
| City | LEWISBURG |
| State | WV |
| Zip Code | 24901-0010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322523 | Lisa Gail Williams | Day Training/Habilitation Specialist | 348 Northridge Dr, Lewisburg, WV 24901-0010 | 2020-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093940 | Amy Lu Moss | Technician | 254 Moss D Lane, Fairlea, WV 24901 | 2020-11-04 |
| 1083212377 | Miranda Shope | Technician | 814 Maple Ave., Lewisburg, WV 24901 | 2020-10-09 |
| 1184235830 | Carol E Beasley | Technician | 147 Windy Hill Road, Lewisburg, WV 24901 | 2020-08-14 |
| 1790317782 | Preston Dyer Modlin | Psychologist | 635 Church Street, Lewisburg, WV 24901 | 2020-02-07 |
| 1437780269 | Healthcare 360 Pllc | Family Medicine | 208 Dawkins Drive, Lewisburg, WV 24901 | 2020-01-30 |
| 1821655390 | Janet Lee Kowalsky | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St., Lewisburg, WV 24901 | 2019-05-21 |
| 1598321192 | Ali Yousaf | Student in an Organized Health Care Education/Training Program | 400 North Jefferson, Lewisburg, WV 24901 | 2019-05-20 |
| 1770053308 | Micheala Renae Taylor | Student in an Organized Health Care Education/Training Program | 1464 North Jefferson Street, Lewisburg, WV 24901 | 2018-11-27 |
| 1659840486 | Maggie King Clendenen | Nurse Practitioner | 454 Bell Drive, Lewisburg, WV 24901 | 2018-11-22 |
| 1861979312 | Vincent Morra | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St, Lewisburg, WV 24901 | 2018-07-26 |
| Find all providers in zip 24901 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837586 | Clorinda L Workman | Registered Nurse | 221 Bright of America Road, Summersville, WV 26651 | 2020-07-01 |
| 1528684479 | Kimberly Dawn Coleman | Registered Nurse | 509 Woodrow Rd, Marlinton, WV 24954-6725 | 2020-06-17 |
| 1154674414 | Tammera L. Nutter | Registered Nurse | Rr 3 Box 42b, Clarksburg, WV 26301-9523 | 2012-10-23 |
| 1598827057 | Donna J Meadows | Registered Nurse | 1824 Murdoch Ave Bldg C, Parkersburg, WV 26101-3230 | 2006-12-14 |
| 1093790545 | Angela D Graham | Registered Nurse | 3375 Us Route 60, Huntington, WV 25705-2837 | 2005-12-07 |
| 1194342089 | Angela Malcomb | Registered Nurse | 804 Broad St, Summersville, WV 26651-1796 | 2020-06-26 |
| 1770109399 | Kathryn Dayle Keaton | Registered Nurse | 804 Industrial Park Rd Ste 1, Maxwelton, WV 24957-8066 | 2020-06-19 |
| 1467077362 | Julia Christian Bays | Registered Nurse | 804 Broad St, Summersville, WV 26651-1796 | 2020-06-16 |
| 1871016725 | Rachelle Hamrick | Registered Nurse | 70 Parcoal Rd, Webster Springs, WV 26288-9767 | 2017-07-24 |
| 1811425432 | Julie Lynn Beiter | Registered Nurse | 310 American Way Ste A, Weirton, WV 26062-4083 | 2017-05-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.