NPIMap

Individual provider Active NPI

Lindsay C. Ketzner, MD

  • Family Medicine Physician
  • Thorntown, IN
National Provider Identifier
1366805509
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082589A Issued in IN
Practice address
151 E Bow St
Thorntown, IN 46071-1164
Phone
(765) 436-2400
Fax
(765) 436-7375
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01082589A IN Primary

Addresses

Primary practice location

151 E Bow St
Thorntown, IN 46071-1164

Mailing address

2605 N Lebanon St
Lebanon, IN 46052-1476

Other identifiers 1

IdentifierTypeStateIssuer
201365430MedicaidIN

Other names 1

  • Lindsay C. Cornett Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lketzner@withamdirect.org Health Information Exchange (HIE) Witham Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191010001937 IN Practitioner - Family Practice 3971894593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2705 N Lebanon St
Lebanon, IN 46052-8622

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions19
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital Family Medicine CurrentSince Sep 9, 2019 Accepting new patients
Witham Memorial Hospital CurrentSince Sep 9, 2019 Accepting new patients

Locations

400 N Mount Zion Rd
Lebanon, IN 46052
Phone (765) 335-0123

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2705 N Lebanon St
Ste 305
Lebanon, IN 46052
Phone (765) 485-8677

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

151 E Bow St
Thorntown, IN 46071
Phone (765) 436-2400

6085 Heartland Dr
Ste 204
Zionsville, IN 46077
Phone (317) 768-2134

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1366805509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E BOW ST",
            "city": "THORNTOWN",
            "state": "IN",
            "postal_code": "460711164",
            "telephone_number": "765-436-2400",
            "fax_number": "765-436-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETZNER",
        "first_name": "LINDSAY",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082589A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201365430",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lketzner@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "151 E Bow St",
            "city": "Thorntown",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460711164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "CORNETT",
            "middle_name": "C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thorntown, IN

Sources for this page

Verify at the official NPI Registry.