Kathleen Ketelson, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

287380 Issued in AZ

Practice address

4921 E Bell Rd Ste 205
Scottsdale, AZ 85254-6002

Phone

(800) 640-3451

NPI assigned

Oct 6, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Hospital Hospital, Salem, OR, CCN 380051

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.ketelson.1@15938.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spencer J Hardenbrook MD PC

  • Family Medicine Physician
  • Draper, UT
  • NPI 1073909594

  AZ

  Medicare reassignment NPD
• Swiftcare LLC

  • Urgent Care Clinic/Center
  • Salem, OR
  • NPI 1235657156
  Medicare reassignment NPD
• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498

  Nurse Practitioner

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1033428198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 E BELL RD STE 205",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546002",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Wallace Rd NW Ste 140",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "97304",
            "country_code": "US",
            "telephone_number": "888-524-8219",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 NW Monroe Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305508",
            "country_code": "US",
            "telephone_number": "541-754-1369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETELSON",
        "first_name": "KATHLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201050158NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "287380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "201050158NP",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500627501",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Kessler, P.T.
• Constance Pierce Kessler, FNP
• Maury Kessler, O.D.
• Suzanne Lynn Kessner, P.T.
• Raymond H Ketcham, FNP
• Liliana Kettenburg
• Ketteys Exchange for Children and Women Resources
• Kathleen Beverly Keung
• Kevin a Fuciarelli MD PC
• Kevin Concannon LLC

• Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.