Kellie C. Ponder

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT16047 Issued in FL

Practice address

220 N Grove St
Merritt Island, FL 32953-3444

Phone

(814) 227-3590

NPI assigned

Oct 26, 2012

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

• Kellie Staab 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.

• Ap Therapy LLC

  • Physical Therapist
  • Englewood Cliffs, NJ
  • NPI 1699552646

  FL, Occupational Therapist

  Medicare reassignment NPD
• Ap Therapy LLC

  • Physical Therapist
  • League City, TX
  • NPI 1821823717

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1386997476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N GROVE ST",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N GROVE ST",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533444",
            "telephone_number": "814-227-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "KELLIE",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT16047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "STAAB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Colvin Petsos, BPHARM
• Danielle L Phillips, BA
• Tara Phu
• Robert B Pierce, CNM
• Denise April Pistilli, RN BSN
• James Earl Poppell Jr., MSPT
• Melissa Posey
• Alison Powell, OT
• Maria Powell, RDH
• Srinivas Prasad, MD

• Occupational Therapist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2025; 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.