Kettelie Henry, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11002547 Issued in FL

Practice address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915

Phone

(877) 226-8874

Fax

(877) 366-4776

NPI assigned

Jun 7, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harbor Palliative Care Services, Inc.Group PAC ID 3476738527, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DFGADD/Endpoint/DFGADD
• FHIR API: https://fhir4.healow.com/fhir/r4/BJJAED/Endpoint/BJJAED

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.

• First Choice Advance Mobile Wound Care

  • Nurse Practitioner
  • West Palm Beach, FL
  • NPI 1942176375
  Medicare reassignment NPD Authorized official
• Harbor Palliative Care Services, Inc.

  • Internal Medicine Physician
  • West Palm Beach, FL
  • NPI 1710283015
  Medicare reassignment Care Compare group NPD
• My Home Doctor, LLC

  • Attendant Care Provider
  • Coral Gables, FL
  • NPI 1902099104
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• JFK Medical Center Limited Partnership

  dba HCA Florida JFK Hospital

  • General Acute Care Hospital
  • Atlantis, FL
  • NPI 1326085424
  Care Compare affiliation

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1013576511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "800-226-8874",
            "fax_number": "877-366-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "877-226-8874",
            "fax_number": "877-366-4776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Imperial Lake Rd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334131075",
            "country_code": "US",
            "telephone_number": "561-254-2352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KETTELIE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bert J Henkel, DPM
• Suzanne Marie Hennessey, LCSW
• Henry Alexander Spratt MD, PA
• Henry Wodnicki, M.D., P.a.
• Horace Henry
• Aquinnah Pierre Herard
• Glenda Herbello, PA-C
• Herman a. Nadal MD PA
• Felix Ernesto Hernandes Alfonso
• Ailin Hernandez Calzadilla

• Family Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.