Kettlyne Kettlyne Exama

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

11113 Lake Tahoe Dr # 111
Riverview, FL 33569-2927

Phone

(813) 466-9076

NPI assigned

Mar 29, 2021

Last updated

Mar 29, 2021By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1710564208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11113 LAKE TAHOE DR # 111",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692927",
            "telephone_number": "813-466-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11113 LAKE TAHOE DR # 111",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692927",
            "telephone_number": "813-466-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXAMA",
        "first_name": "KETTLYNE",
        "middle_name": "KETTLYNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Riverview, FL
• Providers in Riverview, FL by specialty
• Non-emergency Medical Transport (VAN) in Florida

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

Verify at the official NPI Registry.