Jacki Ketner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01691700 Issued in NJ

Practice address

570 Egg Harbor Rd Ste C4
Sewell, NJ 08080-2359

Phone

(609) 267-9400

Fax

(609) 267-9457

NPI assigned

May 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1831689694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EVES DR STE A100",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533126",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 EGG HARBOR RD STE C4",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802359",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "994 W Sherman Ave Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606937",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "609-267-9457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETNER",
        "first_name": "JACKI",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01691700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "40QA01691700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kennedy University Hospital, Inc
• Kennedy University Hospital, Inc
• Kennedy University Hospital, Inc
• Alexandra L Kenyon, MA
• Melissa Kerr, DPT
• Malini M Khanna, M.D.
• KHS Ambulatory Surgery Center, LLC
• Jeffrey A Kimelman, DMD
• Alexander King
• Alina King

• Physical Therapist in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.