Thomas Kettlewell

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ED0642A Issued in WV

Practice address

302 W Main St
Saint Clairsville, OH 43950-8801

Phone

(740) 232-6210

NPI assigned

Jan 4, 2017

Last updated

Apr 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal Medicine

Education

West Virginia School of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnesville Hospital Association, Inc.Group PAC ID 9335134592, 16 clinicians

Reynolds Memorial Hospital, IncGroup PAC ID 9830184530, 152 clinicians

Harrison Community Hospital Inc.Group PAC ID 3173511540, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013
• Barnesville Hospital Association, Inc Hospital, Barnesville, OH, CCN 361321
• Harrison Community Hospital Hospital, Cadiz, OH, CCN 361311

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkettlewell143956@direct.wvuhsdirect.com

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.

• Barnesville Hospital Association, Inc.

  dba Barnesville Hospital

  • Critical Access Hospital
  • Barnesville, OH
  • NPI 1235135450
  Medicare reassignment Care Compare group NPD
• Harrison Community Hospital, Inc.

  • Critical Access Hospital
  • Cadiz, OH
  • NPI 1134151137
  Medicare reassignment Care Compare group NPD
• Reynolds Memorial Hospital, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Glen Dale, WV
  • NPI 1518068014

  OH

  Medicare reassignment Care Compare group
• Barnesville Hospital Association, Inc.

  • Rural Health Clinic/Center
  • Barnesville, OH
  • NPI 1134827546
  NPD
• Belmont County Health Services Inc

  dba Custer Pharmacy

  • Community/Retail Pharmacy
  • Cadiz, OH
  • NPI 1588142806
  NPD
• Reynolds Memorial Hospital, Inc

  • General Acute Care Hospital
  • Glen Dale, WV
  • NPI 1144228305
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnesville Hospital Association, Inc.

  dba Barnesville Hospital

  • Critical Access Hospital
  • Barnesville, OH
  • NPI 1235135450
  Care Compare affiliation
• Harrison Community Hospital, Inc.

  • Critical Access Hospital
  • Cadiz, OH
  • NPI 1134151137
  Care Compare affiliation
• Reynolds Memorial Hospital, Inc

  • General Acute Care Hospital
  • Glen Dale, WV
  • NPI 1144228305
  Care Compare affiliation

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1457896185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508801",
            "telephone_number": "740-232-6210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "426 8th St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381451",
            "country_code": "US",
            "telephone_number": "304-221-4575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Wheeling Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381660",
            "country_code": "US",
            "telephone_number": "304-845-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTLEWELL",
        "first_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "50.007974",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "ED0642A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkettlewell143956@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "300 W Main St Ste 302",
            "city": "St Clairsvle",
            "state": "OH",
            "country_code": "US",
            "postal_code": "439508801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkettlewell143956@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "300 W Main St",
            "city": "St Clairsvle",
            "state": "OH",
            "country_code": "US",
            "postal_code": "439508801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deidra Keller
• Shannan K Kemp Watson, MSW, LISW-S
• Melissa Noel Kempson-Gadd, LPN
• Daniele Kendjorsky
• Brittany Ann Kenworthy
• Jacob Keyser
• Keystone Rehabilitation Systems Inc
• Keystone Rehabilitation Systems, Inc. (Keystone Physical Therapy)
• Khoury Surgical Group, Inc. (Vascular Lab)
• Khoury Vascular & Vein Inc

• Internal Medicine Physician in Saint Clairsville, OH
• Providers in Saint Clairsville, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.