Jaclyn Keefer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT39779 Issued in FL

Practice address

1921 Ortega St
Navarre, FL 32566-4111

Phone

(850) 936-8919

NPI assigned

May 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jaclyn Sidow Former name

Medicare fee-for-service enrollment

Enrolled in OR

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.

• Oregon Healthcare Resources, LLC

  • Multi-Specialty Clinic/Center
  • Eugene, OR
  • NPI 1982907572
  Medicare reassignment NPD
• Gulf Breeze Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Pensacola, FL
  • NPI 1730183153

  Physical Therapist

  NPD (past)
• A Step Ahead Pediatric Therapy PLLC

  • Multi-Specialty Clinic/Center
  • Crestview Hills, KY
  • NPI 1093844177
  NPD (past)
• Rehabclinics SPT Inc

  • Physical Therapist
  • Eldersburg, MD
  • NPI 1164427092
  NPD (past)

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1265007744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3347 NANDALE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452394013",
            "telephone_number": "513-479-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 ORTEGA ST",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325664111",
            "telephone_number": "850-936-8919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 Edwards Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452091288",
            "country_code": "US",
            "telephone_number": "513-221-1100",
            "fax_number": "513-684-4501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Thomas More Pkwy Ste 102",
            "address_purpose": "LOCATION",
            "city": "Crestview Hills",
            "state": "KY",
            "postal_code": "410173421",
            "country_code": "US",
            "telephone_number": "859-426-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "JACLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT-008387",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT019170",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "SIDOW",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tameca Allison Jones, MS
• Joseph Vistitsky DC PA
• Joshua D Pickett DC PA
• Journey Center Counseling
• Norma Kea
• Kids Care Pediatrics of NW FL Inc
• Kids Cove Counseling, PLLC
• Zoe Claire Kinsey, PTA
• Sina Kipry
• Phoenix Marie Klemann, LCSW

• Physical Therapist in Navarre, FL
• Providers in Navarre, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.