KEYONNA STURDIVANT (NPI# 1790390631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790390631 |
| Entity Type | Individual |
| Full Name | KEYONNA STURDIVANT |
| Practice Address |
601 S Martin Luther King Jr Dr Fl 432 Winston Salem NC 27110-0003 |
| Mailing Address |
601 S Martin Luther King Dr Winston Salem NC 27110-0001 |
| Practice Telephone | 3367503177 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
601 S MARTIN LUTHER KING JR DR FL 432 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27110-0003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652504 | Emily Claire Skoglund | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 | 2020-09-03 |
| 1366057093 | Valarie Gaines | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-10 |
| 1407460355 | Shy'ann Frazier | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-08 |
| 1639783517 | Brittany Moran | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-08 |
| 1457965337 | Tauriana Jmia Ragin | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-08 |
| 1114531183 | Alexander Dergins | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 | 2020-09-07 |
| 1386258416 | Laura Brooke Jenkins | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-05 |
| 1053925180 | Brianna Ciara Fleming | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-05 |
| 1134733272 | Kaelove Brena Richardson | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-05 |
| 1295349363 | Lauren Jane Tait | Occupational Therapist | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0003 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652454 | Erica Shade | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 | 2020-09-05 |
| 1841804838 | Lisa Hartwell | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 | 2020-09-07 |
| 1801140702 | Dina Vallabh | Speech-Language Pathologist | 155 Baker House Trent Drive, Durham, NC 27110 | 2012-10-31 |
| 1386258432 | Valerie Miller | Student in an Organized Health Care Education/Training Program | 601 Mlk Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1942814074 | Joyous Hawkins | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1306450408 | Katlyn Maiolo | Occupational Therapist | 601 Martin Luther King Jr. Drive, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2020-09-04 |
| 1649884701 | Lila Grafius | Occupational Therapist | 601 Martin Luther King Dr 432 Fl Atkins Building, Winston Salem, NC 27110-0001 | 2020-09-04 |
| 1366927659 | Judy Larose Foxworth | Physical Therapist | 601 S Mlk Jr Drive F L Atkins Bldg Rm 333, Winston Salem, NC 27110-0001 | 2018-10-02 |
| 1285138123 | Jessica Um | Occupational Therapist | 601 Martin Luther King Jr Dr, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2018-03-23 |
| 1356427793 | Sharon Ambuske Prybylo | Physical Therapist | 330 Fl Atkins, 601 Mlk Jr. Drive, Winston Salem, NC 27110-0001 | 2006-10-28 |
| Find all providers in zip 27110 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659747 | Lakisha Henry-simmons | Student in an Organized Health Care Education/Training Program | 4298 Falcon Rd, Winston Salem, NC 27106-9425 | 2020-11-03 |
| 1366040503 | William Tommy Sparks | Student in an Organized Health Care Education/Training Program | 1012 S Hawthorne Rd, Winston Salem, NC 27103-4419 | 2020-10-10 |
| 1386258432 | Valerie Miller | Student in an Organized Health Care Education/Training Program | 601 Mlk Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1942814074 | Joyous Hawkins | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1326652504 | Emily Claire Skoglund | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 | 2020-09-03 |
| 1750903233 | Rachel Elizabeth Crespi | Student in an Organized Health Care Education/Training Program | 3517 Summerfield Ln, Winston Salem, NC 27106-4295 | 2020-05-07 |
| 1023639325 | Christopher Gregg Marler Jr. | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd Winston-salem N Surgery Clinic, Winston Salem, NC 27157-0001 | 2020-04-28 |
| 1912526005 | Hunter Bright Yancey | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center 1 Me, Winston Salem, NC 27157-0001 | 2020-04-09 |
| 1033748371 | Chukwuweike U Gwam | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Medical Center Boul, Winston Salem, NC 27157-0001 | 2020-04-08 |
| 1386273175 | Mehrnoosh Ghandili | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Health One Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-04-03 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27110 |
Please comment or provide details below to improve the information on KEYONNA STURDIVANT.
| 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.