Jacqueline Grace Kettler, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

23228 Issued in FL

Practice address

150 Village Crossing CT
Saint Augustine, FL 32084-8697

Phone

(502) 694-5241

NPI assigned

Dec 18, 2023

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

Other names 1

• Dr. Jacqueline Grace Engelbrecht Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Burke Collins Therapy, Inc

  • Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1306729330
  Medicare reassignment NPD
• H2 Rehabilitation Services of Florida LLC

  • Rehabilitation Clinic/Center
  • Lakewood Ranch, FL
  • NPI 1275285926
  Medicare reassignment NPD
• Burke Collins Therapy, Inc

  • Rehabilitation Clinic/Center
  • Lakewood Ranch, FL
  • NPI 1144963737
  NPD
• H2 Rehabilitation Services of Florida LLC

  • Rehabilitation Clinic/Center
  • West Melbourne, FL
  • NPI 1366269144
  NPD
• Burke Collins Therapy, Inc

  • Rehabilitation Clinic/Center
  • Palm Coast, FL
  • NPI 1063155653
  NPD (past)
• On Site Dermatology LLC

  • Dermatology Physician
  • Boca Raton, FL
  • NPI 1215978713
  NPD (past)

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1003684119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 GOLDEN LAKE LOOP",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320845899",
            "telephone_number": "417-385-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VILLAGE CROSSING CT",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320848697",
            "telephone_number": "502-694-5241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Cypress Point Pkwy",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321647412",
            "country_code": "US",
            "telephone_number": "386-247-0967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTLER",
        "first_name": "JACQUELINE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "23228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "ENGELBRECHT",
            "middle_name": "GRACE",
            "prefix": "DR.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Alston Kerllenevich, PH.D.
• Marcy Kerr, OTR
• Carl Kesgen, PHARM.D.
• Katie Kestner
• Hailee A Ketterer
• Kevon E. Rennie DMD, P.a.
• Mohammad Khalid, MD
• Shahmir Akbar Khan, DDS
• Anwar S Khokhar, MD
• Taylor Kieffer, AUD

• Occupational Therapist in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.