Timothy Usher Ketterson Jr., PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY7453 Issued in FL

Practice address

4965 SW 91St Ter
Suite a
Gainesville, FL 32608-8149

Phone

(352) 337-0551

Fax

(352) 374-2166

NPI assigned

Jan 29, 2007

Last updated

Nov 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1225174220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 SW 91ST TER",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088149",
            "telephone_number": "352-337-0551",
            "fax_number": "352-374-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 SW 91ST TER",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088149",
            "telephone_number": "352-337-0551",
            "fax_number": "352-374-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERSON",
        "first_name": "TIMOTHY",
        "middle_name": "USHER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY7453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Shulman Kerr, DMD
• Talana Kersey, LMHC
• Jesse Brandon Kershner, O.D.
• Ishaan Keshwani
• Sandhya Keskar, MOT
• Tyler Douglas Kettlewell, MSW STUDENT
• Key Haven Management Group, LLC (Touching Hearts at Home Florida)
• Janyzha Key
• Nicole Joan Keyes
• Brandon L Keys, APRN

• Counseling Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.