1. Home
  2. Directory
  3. Florida
  4. Ormond Beach
  5. Clinic Center
  6. NPI Profile

LIFE IS KETAFUL
NPI 1396398608
Clinic/Center - Health Service in Ormond Beach, FL

Active since July 17, 2019
495 S NOVA RD STE 101A, ORMOND BEACH, FL 32174(386) 487-4673(855) 829-5770 Get Directions Write a Review

NPPES record last updated: August 7, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 7, 2020, May 22, 2020, Dec 20, 2019 and 1 more (4 updates tracked since 2019).

About Life Is Ketaful NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE IS KETAFUL (NPI 1396398608) is a healthcare organization registered as a health service in Ormond Beach, Florida and active in the NPI registry since July 2019. The organization maintains a secondary practice location in Port Orange and lists William Louis Self, Owner, as its authorized official.

NPPES Registry Identity

NPI1396398608
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameJACKSON REEF
Location Address495 S NOVA RD STE 101AOrmond Beach, FL 32174-8444
Mailing Address495 S Nova Rd Ste 101aOrmond Beach, FL 32174-8444 · (386) 487-4673 · Fax (855) 829-5770
Phone(386) 487-4673
Fax(855) 829-5770
Organization SubpartNo
Authorized OfficialWilliam Louis SelfOwner · (386) 487-4673
Enumeration DateJuly 17, 2019
Last NPPES UpdateAugust 7, 20204 updates tracked since enumeration
NPPES CertifiedAugust 7, 2020
✔ NPI 1396398608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
495 S NOVA RD STE 101A, Ormond Beach, FL 32174
Open in Google Maps ↗

Other Names 1

Doing Business AsLife Is Ketaful

Secondary Practice Location 1

Location 1851 Dunlawton Ave Ste 103Port Orange, FL 32127-4234 · Phone (386) 487-4673 · Fax (855) 829-5779

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM SELF
Nurse Anesthetist, Certified Registered
495 S NOVA RD STE 101A
ORMOND BEACH, FL 32174
Flagler County (386) 487-4673
ZENTHEO LLC
Psychiatry & Neurology (Psychiatry)
495 S NOVA RD STE 101A
ORMOND BEACH, FL 32174
Flagler County (386) 487-4673

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Reef's NPI number?

The NPI number for Jackson Reef is 1396398608. It was assigned to this organization in the NPPES registry on July 17, 2019. The provider is doing business as Life Is Ketaful.

Where is Jackson Reef located?

Jackson Reef is located at 495 S Nova Rd Ste 101A, Ormond Beach, FL 32174. The listed phone number is (386) 487-4673.

What is Jackson Reef's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Jackson Reef was last updated on August 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.