Ellen L Ketterling, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5100 Issued in ND

Practice address

1000 Highway 12
Hettinger, ND 58639

Phone

(701) 567-4561

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245323930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "586397533",
            "telephone_number": "701-567-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 12",
            "city": "HETTINGER",
            "state": "ND",
            "postal_code": "58639",
            "telephone_number": "701-567-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERLING",
        "first_name": "ELLEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ND",
            "license": "5100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Hulm
• Thomas E Jacobsen, MD
• Kali Jacobson
• John P Joyce, MD
• Jessica Marie Kautz
• Steven C Kilwein, DPM
• Jacqueline Kling, LSW
• Lesley D Kling, FNP
• Isaiah Kludt
• John F Kludt, OD

• Pediatrics Physician in Hettinger, ND
• Providers in Hettinger, ND by specialty
• Pediatrics Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.