Andrew Kettner

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

94-09814 Issued in KS

Practice address

1010 N Kansas St
Wichita, KS 67214-3124

Phone

(316) 293-2665

NPI assigned

May 21, 2019

Sex

Male

Sole proprietor

No

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

Enrolled in KS

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

Specialty

Family Practice

Education

University of Kansas School of Med (KC/Wich/Sal), 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Wichita Family Physicians, P.a.Group PAC ID 5799745717, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoenix Home Care Home health agency, Wichita, KS, CCN 178012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EJDEBA
• Direct secure messaging: andrew.kettner@wwfp.eclinicaldirectplus.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.

• West Wichita Family Physicians, P.a.

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1043228984
  Medicare reassignment Care Compare group NPD
• West Wichita Family Physicians, P.a.

  • Ambulatory Surgical Clinic/Center
  • Wichita, KS
  • NPI 1790902617
  NPD
• West Wichita Family Physicians, P.a.

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1902810302
  NPD

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

• Proactive Home Care, LLC

  • Home Health Agency
  • Wichita, KS
  • NPI 1013979905
  Care Compare affiliation

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1164089660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTNER",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-09814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather L. Kessler, PSYD, LP
• Thu Kester-Phan
• Janine Kesterson-Cravens, PH.D, BCBA-D
• Daniel Ketema, M.D.
• Halie Ketola
• Melissa Ramos Keusler, OD
• Kayla R Keuter, PA
• Kevin F Brown DO PC
• Kevin K. Christensen, D.D.S., P.a.
• Kevin Paul Rieg

• Family Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.