Kettlie Joseph Daniels, MD, Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35057621 Issued in OH

Legal business name

KETTLIE JOSEPH DANIELS, MD, INC.

Practice address

980 S Byrne Rd
Toledo, OH 43609-1010

Phone

(419) 842-0140

Fax

(419) 842-0142

NPI assigned

Oct 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kettlie Joseph Daniels, MDNPI 1790775054

Title

President

Phone

(419) 842-0140

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kettlie Joseph Daniels, MD

  • Specialist
  • Toledo, OH
  • NPI 1790775054
  NPD (past) Authorized official

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1144539412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 S BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436091010",
            "telephone_number": "419-842-0140",
            "fax_number": "419-842-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 S BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436091010",
            "telephone_number": "419-842-0140",
            "fax_number": "419-842-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTLIE JOSEPH DANIELS, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "KETTLIE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-842-0140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35057621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori J Kertesz, RPH, CACP
• Julia Christine Kessel, MD
• Spencer Gregory Norman Kessen
• Rebecca Kaye Ketchum
• Kelli Ketring, LPCC-S
• David S. Kevorkian, RPH
• Lasharia Key
• Pauline L Key
• Keys 2 Independent Living, LLC
• Lenora Keys

• Psychiatry Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.