Active NPI
Jennifer Hope Kettler, CRNA
- Certified Registered Nurse Anesthetist
- Memphis, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 20318
- Practice address
- 1265 Union Ave
Memphis, TN 38104-3415 - Phone
- (901) 725-5846
- NPI assigned
- Mar 28, 2015
- Last updated
- Dec 30, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 20318 | TN | Primary |
| Registered Nurse | 163W00000X | RN0000135833 | TN |
Addresses
Primary practice location
1265 Union Ave
Memphis, TN 38104-3415
Mailing address
6060 Primacy Pkwy
Suite 241
Memphis, TN 38119-5745
Phone (901) 725-5846
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6242 W Andrew Johnson Hwy
Talbott, TN 37877-8604
Phone (423) 690-3274
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000135833 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Tennessee, P.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| American Anesthesiology of Tennessee, P.C. | Current | Accepting new patients | |
| Lifelinc Anesthesia VIII PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Medical Anesthesia Group, PA | Current | Accepting new patients | |
| Lifelinc Anesthesia, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Lifelinc Anesthesia II, PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
7600 Airways Blvd
Ste D
Southaven, MS 38671
Phone (662) 349-7477
2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000
1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140
110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431
9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040
1044 Cresthaven Rd
Memphis, TN 38119
Phone (662) 470-5029
1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362
1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000
1755 Kirby Pkwy
Ste 330
Memphis, TN 38120
Phone (901) 725-5846
2200 Union Ave
Memphis, TN 38104
Phone (901) 274-5813
255 S Pauline St
Memphis, TN 38104
Phone (901) 261-2804
5999 Park Ave
Memphis, TN 38119
Phone (901) 818-1080
6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846
80 Humphreys Center Dr
Ste 310
Memphis, TN 38120
Phone (901) 474-3370
435 2nd St
Newport, TN 37821
Phone (423) 625-2200
100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531
6242 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 690-3250
Organizations & group practices 7
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.
-
- Anesthesiology Physician
- Newport, TN
- NPI 1679265052
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Knoxville, TN
- NPI 1609822998
-
- Anesthesiology Physician
- Springfield, TN
- NPI 1821397233
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1801021464
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1679527501
-
- Anesthesiology Physician
- Memphis, TN
- NPI 1578592663
-
- Certified Registered Nurse Anesthetist
- Knoxville, TN
- NPI 1245279777
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1144614058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6060 PRIMACY PKWY",
"address_2": "SUITE 241",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381195745",
"telephone_number": "901-725-5846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 UNION AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381043415",
"telephone_number": "901-725-5846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTLER",
"first_name": "JENNIFER",
"middle_name": "HOPE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-28",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "20318",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "RN0000135833",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.