Individual provider Active NPI

James Ketterman, CRNA

  • Certified Registered Nurse Anesthetist
  • Enid, OK
National Provider Identifier
1457539454
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN71292 Issued in OK
Practice address
305 S 5TH St
Enid, OK 73701-5832
Phone
(580) 233-6100
NPI assigned
Feb 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN71292 OK Primary

Addresses

Primary practice location

305 S 5TH St
Enid, OK 73701-5832

Mailing address

305 S 5TH St
Enid, OK 73701-5832
Phone (580) 233-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080422000399 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 8426136144 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians

Practice addresses (Care Compare)

5925 NW 139TH St
Oklahoma City, OK 73142-1922
Phone (405) 621-8800

8100 S Walker Ave
BLDG C
Oklahoma City, OK 73139-9404
Phone (405) 602-6500

Hospital & facility affiliations

  • Oklahoma Center for Orthopaedic & Multi-SP Hospital, Oklahoma City, OK, CCN 370212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN71292OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Professionals, PLLC CurrentSince Jun 1, 2022 Accepting new patients
Orthomed Staffing LLC CurrentSince Feb 19, 2024 Accepting new patients
Western Oklahoma Anesthesia Consultants PLLC CurrentSince Jul 1, 2021 Accepting new patients
Enid Surgical Anesthesia LLC CurrentSince Oct 14, 2015 Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

1133 W Willow Rd
Enid, OK 73703
Phone (580) 233-7171

8100 S Walker Ave
Bldg C
Oklahoma City, OK 73139
Phone (405) 602-6500

100 SE 59th St
Oklahoma City, OK 73129
Phone (405) 364-9789

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

Organizations & group practices 4

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 1

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": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1457539454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S 5TH ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015832",
            "telephone_number": "580-233-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S 5TH ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015832",
            "telephone_number": "580-233-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERMAN",
        "first_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "RN71292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.

Verify at the official NPI Registry.