MRS. KEISHA DIANE MALONE (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1366177156

MRS. KEISHA DIANE MALONE (PMHNP-BC) is a healthcare provider. based in Redford, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 4704301992 (MI). The NPI Number for MRS. KEISHA DIANE MALONE (PMHNP-BC) is 1366177156

Main info

Female
Sole Proprietor
4 Years Of Experience
Name
MRS. KEISHA DIANE MALONE (PMHNP-BC)
NPI
1366177156
Phone
(313) 207-5843
Address
15611 FOX
Enumeration Date
18 July 2022
Last Update Date
18 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
5193108504
Professional Enrollment ID
I20260331001927
Address ID
FL331301807MI66XXXSTXX400

Contacts

Main Contact
kport_04@yahoo.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

8,106 NURSE PRACTITIONER in MI

Provider Addresses for MRS. KEISHA DIANE MALONE (PMHNP-BC)

  • 15611 FOX

    REDFORD, MI 482393976

    Phone: (313) 207-5843

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $250.

Total Amount is formed as General ($250) + Research ($0) + Ownership ($0) = $250.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Lundbeck LLC ($51).

Total Amount

$250

General + Research + Ownership

Payments

13

Total payment records

General Amount

$250

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-08-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220818000197INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48239)

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Reviews

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Frequently asked questions

Can I use this page to confirm MRS. KEISHA DIANE MALONE (PMHNP-BC)'s NPI?
Yes. MRS. KEISHA DIANE MALONE (PMHNP-BC) is listed with NPI 1366177156 in the public NPI dataset.
Does CMS list MRS. KEISHA DIANE MALONE (PMHNP-BC) as active?
Yes — MRS. KEISHA DIANE MALONE (PMHNP-BC) is active in the NPI listing used on this page.
What is MRS. KEISHA DIANE MALONE (PMHNP-BC) best known for clinically?
Directory data describes MRS. KEISHA DIANE MALONE (PMHNP-BC) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does MRS. KEISHA DIANE MALONE (PMHNP-BC) list a practice location?
Patients near Redford, Michigan may find MRS. KEISHA DIANE MALONE (PMHNP-BC) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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