Active NPI
Joy Carissa Keckler, COTA
- Occupational Therapy Assistant
- Deltona, FL
National Provider Identifier
1427562800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 16114
- Practice address
- 3301 Croton Ave
Deltona, FL 32738-1479 - Phone
- (386) 848-5875
- NPI assigned
- Nov 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 16114 | FL | Primary |
Addresses
Primary practice location
3301 Croton Ave
Deltona, FL 32738-1479
Mailing address
3301 Croton Ave
Deltona, FL 32738-1479
Phone (386) 848-5875
Other practice location 1
3301 Croton Ave
Deltona, FL 32738-1479
Phone (386) 848-5875
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16114 | FL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimum Rehab, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Lake Mary, FL
- NPI 1285788083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632873600000",
"number": "1427562800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 CROTON AVE",
"city": "DELTONA",
"state": "FL",
"postal_code": "327381479",
"telephone_number": "386-848-5875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 CROTON AVE",
"city": "DELTONA",
"state": "FL",
"postal_code": "327381479",
"telephone_number": "386-848-5875"
}
],
"practiceLocations": [
{
"address_1": "3301 Croton Ave",
"address_purpose": "LOCATION",
"city": "Deltona",
"state": "FL",
"postal_code": "327381479",
"country_code": "US",
"telephone_number": "386-848-5875",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KECKLER",
"first_name": "JOY",
"middle_name": "CARISSA",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-21",
"last_updated": "2021-09-29",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "16114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.