Individual provider Active NPI

Kerri Hotlen

  • Clinical Social Worker
  • Daytona Beach, FL
National Provider Identifier
1770925646
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14878 Issued in FL
Practice address
1220 Willis Ave
Daytona Beach, FL 32114-2810
Phone
(800) 538-4228
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 6801094849 MI
Clinical Social Worker 1041C0700X SW14878 FL Primary

Addresses

Primary practice location

1220 Willis Ave
Daytona Beach, FL 32114-2810

Mailing address

3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14878FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1770925646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 S MACKINAC TRL",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497839286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 WILLIS AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142810",
            "telephone_number": "800-538-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTLEN",
        "first_name": "KERRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094849",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.