Active NPI
Chad Frederick Kettler, MSPT
- Physical Therapist
- Harrisburg, PA
National Provider Identifier
1356631949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012978L
- Practice address
- 4830 Londonderry Rd Ste C
Harrisburg, PA 17109-5207 - Phone
- (717) 724-4888
- Fax
- (717) 652-4203
- NPI assigned
- Apr 15, 2011
- Last updated
- Jul 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012978L | PA | Primary |
Addresses
Primary practice location
4830 Londonderry Rd Ste C
Harrisburg, PA 17109-5207
Mailing address
7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4830 Londonderry Rd
Harrisburg, PA 17109-5207
Phone (717) 657-2595
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT012978L | PA | MD | Physical Therapist |
Organizations & group practices 1
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.
-
- Physical Therapist
- Middleburg, PA
- NPI 1154376937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751932800000",
"number": "1356631949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 DOCK HILL RD",
"city": "MIDDLEBURG",
"state": "PA",
"postal_code": "178428910",
"telephone_number": "570-837-2123",
"fax_number": "570-837-2185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4830 LONDONDERRY RD STE C",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171095207",
"telephone_number": "717-724-4888",
"fax_number": "717-652-4203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETTLER",
"first_name": "CHAD",
"middle_name": "FREDERICK",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-15",
"last_updated": "2025-07-08",
"certification_date": "2025-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT012978L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.