Timothy U Ketterson PHD PA

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PY7453 Issued in FL

Legal business name

TIMOTHY U KETTERSON PHD PA

Practice address

4965 SW 91St Ter
Suite a
Gainesville, FL 32608-8149

Phone

(352) 337-0551

Fax

(352) 374-2166

NPI assigned

Apr 25, 2008

Organization subpart

No

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

Authorized official

Name

Norma A Box

Title

Office Manager

Phone

(352) 337-0551

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1720253297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 SW 91ST TER",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088149",
            "telephone_number": "352-337-0551",
            "fax_number": "352-374-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 SW 91ST TER",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088149",
            "telephone_number": "352-337-0551",
            "fax_number": "352-374-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY U KETTERSON PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "BOX",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-337-0551"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY7453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark J. Timken, MD
• Paul Richard Timler Jr., P.T.
• Kathryn Holland Timmons, M.S.W.
• Victoria Lynn Timmons, PHARM.D.
• Cedric Timol-George
• Tina M Lam M D P a
• Lindsey Hoop Tincher, PHARMD
• Chelsea Tindal
• Kayla Tindall
• Drew Tingey, DO

• Counseling Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.