DR. CORETTA D. KEITH (DNP, FNP-BC) – Nurse Practitioner, NPI 1306884374
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. CORETTA D. KEITH (DNP, FNP-BC)
116 BEOWULF LN
LEESBURG, GA 317635831
Phone: (404) 710-6646
Type: Mailing
300, El Camino Real, Village Meadows, Sierra Vista, Cochise County, Arizona, 85635, United States
SIERRA VISTA, AZ 856352812
Phone: (520) 417-3835
Fax: (520) 417-3828
Type: Location
1029, Paso Robles Avenue, Sierra Vista, Cochise County, Arizona, 85635, United States
SIERRA VISTA, AZ 856358345
Phone: (229) 886-0122
Type: Mailing
901 18TH ST E
TIFTON, GA 317943648
Phone: (229) 382-7120
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $60.
Total Amount is formed as General ($60) + Research ($0) + Ownership ($0) = $60.
Last reported payment date: 2024-10-13 • Largest payer in this snapshot: Medtronic, Inc. ($37).
Total Amount
$60
General + Research + Ownership
Payments
3
Total payment records
General Amount
$60
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $37 |
| Ethicon US, LLC | $22 |
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: 2004-05-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040519000092 | I | Nurse Practitioner | GA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 35 | 35 | $0 |
| 99291 | Critical care, first 30-74 minutes | 18 | 18 | $0 |
Insurance plans in this area (ZIP 31763)
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