Individual provider Active NPI

Kayla Kerner

  • Occupational Therapy Assistant
  • Jacksonville, FL
National Provider Identifier
1679990428
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA11449 Issued in FL
Practice address
6535 Chester Ave
Jacksonville, FL 32217-2250
Phone
(904) 731-8230
NPI assigned
Mar 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131001172 VA
Occupational Therapy Assistant 224Z00000X OTA11449 FL Primary

Addresses

Primary practice location

6535 Chester Ave
Jacksonville, FL 32217-2250

Mailing address

4560 Princess Anne Rd
Virginia Beach, VA 23462-7905
Phone (757) 495-7366

Other practice location 1

4560 Princess Anne Rd
Virginia Beach, VA 23462-7905
Phone (757) 495-7366

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

LicenseStateTypeSpecialty
OTA11449FLMDOccupational Therapy Assistant
0131001172VAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1679990428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234627905",
            "telephone_number": "757-495-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 CHESTER AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172250",
            "telephone_number": "904-731-8230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4560 Princess Anne Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234627905",
            "country_code": "US",
            "telephone_number": "757-495-7366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERNER",
        "first_name": "KAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131001172",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA11449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.

Verify at the official NPI Registry.