Jennifer Beare Ketterman, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AC000834 Issued in MD

Practice address

3304 Hayman Dr
Federalsburg, MD 21632

Phone

(410) 754-2440

NPI assigned

Jun 23, 2010

Last updated

Nov 6, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE, MD2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tidalhealth Physician Network, Inc.

  • Family Medicine Physician
  • Seaford, DE
  • NPI 1467534636

  MD

  Medicare reassignment NPD

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1306157508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 HAYMAN DR",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216322626",
            "telephone_number": "410-754-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 HAYMAN DR",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "21632",
            "telephone_number": "410-754-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Rawlins Drive",
            "address_purpose": "LOCATION",
            "city": "Seaford",
            "state": "DE",
            "postal_code": "19973",
            "country_code": "US",
            "telephone_number": "302-629-4240",
            "fax_number": "302-629-4237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Rawlins Drive",
            "address_purpose": "LOCATION",
            "city": "Seaford",
            "state": "DE",
            "postal_code": "19973",
            "country_code": "US",
            "telephone_number": "302-629-4240",
            "fax_number": "302-629-4237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTERMAN",
        "first_name": "JENNIFER",
        "middle_name": "BEARE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC000834",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "AC000834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306157508",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Hammond, CMHC, PHD ,
• John William Hawkins, DDS
• Jennifer L Hubbert
• John a Appiott DO PC (Federalsburg Family Practice)
• Tiarra Jones-Bbosa, CRNP
• Kendrick Lee, DMD, MS
• Morgan Elizabeth Lushis, P.T.A.
• LW Health Care
• David Allen Martin, DMD
• Lisa May, LCSW-C

• Nurse Practitioner in Federalsburg, MD
• Providers in Federalsburg, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.