Shawn Kettyle

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Practice address

1113 Easton Rd
Willow Grove, PA 19090-1901

Phone

(215) 659-3060

NPI assigned

Dec 22, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1134527369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 JAMISON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163833",
            "telephone_number": "215-253-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 EASTON RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901901",
            "telephone_number": "215-659-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTYLE",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison J. Keen, MD
• Nicky Kelepouris, MD
• Kevin J Kelly, M.D.
• Leslie A Kemper, MMFT
• Kent Lane Mueller DDS, LLC
• Keystone Mobile Partners, LP (Keystone Kidney Center)
• Majid Afzal Khan, M.D.
• Saad Ahmed Khan, MD
• Greg Kidorf, PH.D.
• Erin Lynn Kilkenny, DPT, PT

• Skilled Nursing Facility in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.