Kimberly Villarreal Renner, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT23999 Issued in FL

Practice address

500 Park Ave
Orange Park, FL 32073-3132

Phone

(904) 503-9556

NPI assigned

Mar 15, 2023

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1639870710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 CHESTERWOOD RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320840088",
            "telephone_number": "714-310-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733132",
            "telephone_number": "904-503-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNER",
        "first_name": "KIMBERLY",
        "middle_name": "VILLARREAL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT23999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.