Individual provider Active NPI

Bethany Kette, MD

  • Obstetrics & Gynecology Physician
  • Shiloh, IL
National Provider Identifier
1225666118
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036175176 Issued in IL
Practice address
1414 Cross St Ste 240
Shiloh, IL 62269-2941
Phone
(618) 234-2390
Fax
(618) 234-9936
NPI assigned
Mar 28, 2020
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036175176 IL Primary

Addresses

Primary practice location

1414 Cross St Ste 240
Shiloh, IL 62269-2941

Mailing address

PO Box 959203
Saint Louis, MO 63195-9354
Phone (618) 234-2390

Other practice location 1

110 Irving St NW Dept Of
Washington, DC 20010-3017
Phone (202) 877-8035

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250311000872 DC Practitioner - Obstetrics/Gynecology 9032630710 Reassigns benefits to 2 organizations
I20251021002234 IL Practitioner - Obstetrics/Gynecology 9032630710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1414 Cross St
Shiloh, IL 62269-2941
Phone (618) 607-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036175176ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Oct 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2025 Accepting new patients
WHC Emerg Phys CurrentSince Aug 1, 2024 Accepting new patients
WHC Physician Group LLC CurrentSince Aug 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Mar 1, 2025 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Oct 1, 2025 Accepting new patients
WHC Physician Group LLC Current Accepting new patients
Washington Hospital Center Corporation Past Accepting new patients

Locations

106 Irving St NW
Washington, DC 20010
Phone (202) 877-0275

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1414 Cross St
Ste 240
Shiloh, IL 62269
Phone (618) 234-2390

1103 W Liberty St
Farmington, MO 63640
Phone (573) 760-8488

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6481

965 Mattox Dr
Sullivan, MO 63080
Phone (573) 468-7054

Interoperability endpoints

  • Direct secure messaging: bkette2297603@direct.trinity-health.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1225666118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631959354",
            "telephone_number": "618-234-2390",
            "fax_number": "618-234-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 CROSS ST STE 240",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692941",
            "telephone_number": "618-234-2390",
            "fax_number": "618-234-9936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW Dept Of",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-8035",
            "fax_number": "202-877-5435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTE",
        "first_name": "BETHANY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036175176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1414 Cross St Ste 240",
            "city": "Shiloh",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622692941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

Verify at the official NPI Registry.