Carla Rena Kersey, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT0001047 Issued in FL

Practice address

266 Kidd St
Fort Walton Beach, FL 32548-4478

Phone

(850) 582-2689

Fax

(850) 244-0971

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Crena Kersey Pediatric Occupational Therapist PA

  • Occupational Therapist
  • Fort Walton Beach, FL
  • NPI 1508943820
  NPD Authorized official
• Pediatric Occupational Therapist PA

  • Early Intervention Provider Agency
  • Fort Walton Beach, FL
  • NPI 1972266104
  NPD Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1699793554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 KIDD ST",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484478",
            "telephone_number": "850-582-2689",
            "fax_number": "850-244-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 KIDD ST",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484478",
            "telephone_number": "850-582-2689",
            "fax_number": "850-244-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "CARLA",
        "middle_name": "RENA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT1047",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT0001047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88045088",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002115800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880450800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103169100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli L. Parks, OD, LLC
• Kelly Beck, LMHC
• Thomas J Kelly, DO
• Casey Kennington
• Briana Minette Kent, OTD, OTR/L
• Hannah Elaine Kettle-Church, LPN
• Dawn Kimball Key, LMHC
• Sikandar Khan, MD
• Jessica Lauren Kibe, BCBA
• Tara Nicole Kidd, MSN, APRN, PMHNP-BC

• Pediatric Occupational Therapist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Pediatric Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.