Corey Kettering

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

7194 Issued in AK

Practice address

700 E 34TH Ave
Anchorage, AK 99503-4120

Phone

(330) 936-0142

NPI assigned

Mar 11, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1215320577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2352",
            "city": "CRYSTAL BEACH",
            "state": "TX",
            "postal_code": "776502352",
            "telephone_number": "330-936-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E 34TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034120",
            "telephone_number": "330-936-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERING",
        "first_name": "COREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "7194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kolleen Kessler Ellingboe, MHS
• Dianna Kessler, CST,FA
• Shirley Ketah, MS, CDC1
• Katy Violet Ketchum Smith, M.S.C.P.
• Linden Jane Ketchum, BA
• Ashley Kettler, O.D.
• Ketz Chiropractic LLC
• Kelly Lee Ketz, D.C.
• Kevin M Easley DMD PC
• Kevin M Tomera MD Inc

• Licensed Practical Nurse in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Licensed Practical Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.