Individual provider Active NPI

Ketty Maurice, DO

  • Family Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1053368043
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS8053 Issued in FL
Practice address
636 Del Prado Blvd
Cape Coral, FL 33990-2695
Phone
(239) 424-3123
Fax
(239) 424-4041
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO.2613 AL
Family Medicine Physician 207Q00000X 04090 KY
Adult Medicine Physician 207QA0505X 2022-02636 NC
Family Medicine Physician 207Q00000X OS8053 FL Primary

Addresses

Primary practice location

636 Del Prado Blvd
Cape Coral, FL 33990-2695

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1479

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5680

Other practice location 2

210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone (910) 904-8000

Other identifiers 1

IdentifierTypeStateIssuer
26036830MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY, GU, NC4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20040205000130 FL Practitioner - Family Practice 0446143382 Reassigns benefits to 4 organizations
I20170412001611 KY Practitioner - Family PracticePractitioner - Hospitalist 0446143382 Reassigns benefits to 3 organizations
I20181203001447 GU Practitioner - Internal Medicine 0446143382 Reassigns benefits to 1 organization
I20221117000034 NC Practitioner - Family Practice 0446143382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland County Hospital System IncGroup PAC ID 1850204041, 581 clinicians

Practice addresses (Care Compare)

210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone (910) 904-8000

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO.2613ALMDFamily Medicine Physician
2022-02636NCMDAdult Medicine Physician
2613ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coral Springs Physician Services, LLC CurrentSince Sep 25, 2017 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Jul 8, 2023 Accepting new patients
Cogent Healthcare of Kentucky, PSC Family Medicine CurrentSince Jul 2, 2022 Accepting new patients
Inpatient Consultants of Florida Inc CurrentSince Jun 13, 2016 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Nov 9, 2024 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Jul 8, 2023 Accepting new patients
Cape Coral Hospitalists Inc CurrentSince Feb 9, 2017 Accepting new patients
Cogent Healthcare of North Carolina, PC Family Medicine CurrentSince Sep 18, 2023 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC CurrentSince Jul 2, 2022 Accepting new patients
Hospital Medicine Services of Ky, LLC CurrentSince Nov 10, 2024 Accepting new patients
Owensboro Health Medical Group, Inc. CurrentSince Nov 9, 2024 Accepting new patients
Inpatient Consultants of Florida, Inc Current Accepting new patients
Guam Memorial Hospital CurrentSince Sep 10, 2018 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Baptist Health Deaconess Medical Group Inc Family Medicine Current Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Guam Memorial Hospital CurrentSince Sep 10, 2018 Accepting new patients
Osler Medical Inc Past Accepting new patients
Community Care Resources, Inc. Past Accepting new patients
Oscar H Jerkins, MD, PA Family Medicine PastSince Jul 1, 2001 Accepting new patients

Locations (25 of 26)

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

13681 Doctors Way
Rm 18027
Fort Myers, FL 33912
Phone (239) 210-4247

2801 N State Road 7
Margate, FL 33063
Phone (954) 683-7041

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330

299 Kings Daughters Dr
Hatton, KY 40601
Phone (502) 875-5240

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

900 Hospital Dr
Fl 5
Madisonville, KY 42431
Phone (270) 825-5100

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

800 Hospital Dr
Fl 2
Madisonville, KY 42431
Phone (270) 326-3900

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

210 Medical Pavilion Dr
Raeford, NC 28376
Phone (910) 904-8000

Interoperability endpoints

  • Direct secure messaging: ketty.maurice.1@22755.direct.athenahealth.com
  • Direct secure messaging: ryi9201@yourcarecommunity.org
  • Direct secure messaging: kmaurice106762@capefearvalley.direct-ci.com
  • Direct secure messaging: kmaurice549590@direct.froedtert.com

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1053368043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1479",
            "fax_number": "239-424-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 DEL PRADO BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902695",
            "telephone_number": "239-424-3123",
            "fax_number": "239-424-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-5680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Medical Pavilion Dr",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283769111",
            "country_code": "US",
            "telephone_number": "910-904-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAURICE",
        "first_name": "KETTY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.2613",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04090",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "2022-02636",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS8053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26036830",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.