Myron Edward Ketter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005368 Issued in GA

Practice address

98 Cleveland St Ste C
Blairsville, GA 30512-3564

Phone

(706) 994-5360

Fax

(706) 237-2571

NPI assigned

Feb 20, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1306015656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 CLEVELAND ST STE C",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123564",
            "telephone_number": "706-994-5360",
            "fax_number": "706-237-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 CLEVELAND ST STE C",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123564",
            "telephone_number": "706-994-5360",
            "fax_number": "706-237-2571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "597 Hiawassee Ests",
            "address_2": "Unit 7",
            "address_purpose": "LOCATION",
            "city": "Hiawassee",
            "state": "GA",
            "postal_code": "305462260",
            "country_code": "US",
            "telephone_number": "706-994-5360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2413 Highway 76",
            "address_purpose": "LOCATION",
            "city": "Hiawassee",
            "state": "GA",
            "postal_code": "305462116",
            "country_code": "US",
            "telephone_number": "706-994-5360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTER",
        "first_name": "MYRON",
        "middle_name": "EDWARD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-20",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10957",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8551",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "005368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306015656",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306015656",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003171972B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306015656",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Kevin Karisny, M.D.
• Tina S Keaton, NP-C
• John W Kelley, MD
• Karen Kelley, RPH
• Joshua R Kennedy, D.O.
• Amy Kight, MS, OTR/L
• Sarah Michelle King, L.AC
• King'S Hometown Walk-in Clinic LLC
• Kings Quick Care
• Mariana Leona Kinney, OTR/L

• Clinical Social Worker in Blairsville, GA
• Providers in Blairsville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.