Cara Jane Kettler Daniel, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301091454 Issued in MI

Practice address

6869 S Occidental Rd
Tecumseh, MI 49286-9784

Phone

(517) 423-4777

Fax

(517) 423-7257

NPI assigned

Jul 30, 2006

Last updated

Nov 3, 2023By the provider in NPPES

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 names 1

• Cara Jane Kettler Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdaniel23051@direct.promedica.org

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

• Promedica Central Corporation of Michigan

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1588624696

  MI, Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1104831676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "517-423-4777",
            "fax_number": "517-423-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6869 S OCCIDENTAL RD",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492869784",
            "telephone_number": "517-423-4777",
            "fax_number": "517-423-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "CARA",
        "middle_name": "JANE KETTLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301091454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdaniel23051@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARA",
            "last_name": "KETTLER",
            "middle_name": "JANE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Georgianna Covell, RN
• Creative Counseling Center
• Cunningham Vision Centers
• Thomas G Cunningham, OD
• Dana E Gillin OD PC (Eye Care Center)
• Gail Daniels, LPN
• Mary Beth Darling, NP
• Raquel Dawn Declercq
• Jessica Deleon
• Kenneth L Densmore, D.D.S.

• Pediatrics Physician in Tecumseh, MI
• Providers in Tecumseh, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.