Elena Marie Ketner, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

207300 Issued in OK

Practice address

3401 W Gore Blvd
Lawton, OK 73505-6332

Phone

(580) 355-8620

NPI assigned

Feb 10, 2014

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 OK

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comanche County Hospital AuthorityGroup PAC ID 2668373689, 54 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Hospital, Lawton, OK, CCN 370056

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 and National Provider Directory roles.

• Comanche County Hospital Authority

  • Federally Qualified Health Center (FQHC)
  • Lawton, OK
  • NPI 1588832869
  Medicare reassignment Care Compare group NPD
• Comanche County Hospital Authority

  • Community/Retail Pharmacy
  • Lawton, OK
  • NPI 1427130947
  NPD
• Comanche County Healthcare

  • Surgery Physician
  • Lawton, OK
  • NPI 1285651232
  NPD (past)
• Comanche County Hospital Authority

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

• Comanche County Hospital Authority

  • Land Ambulance
  • Walters, OK
  • NPI 1285181610

  Hospital

  Care Compare affiliation
• Comanche County Hospital Authority

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379
  Care Compare affiliation
• Comanche County Hospital Authority

  • Land Ambulance
  • Lawton, OK
  • NPI 1770525883

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1497179543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 SW A Ave",
            "address_purpose": "LOCATION",
            "city": "Lawton",
            "state": "OK",
            "postal_code": "735013930",
            "country_code": "US",
            "telephone_number": "580-248-5780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETNER",
        "first_name": "ELENA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "207300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497179543",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert L Kern, MD
• Cassondra Kerr
• Cassandra Marie Kerrigan Redwine
• Beaux Grant Ketchum
• Charles Lee Ketner
• Trina Kettrles
• Kevin M. Riccitelli, D.O. LLC.
• Dana Marie Key
• Samiya Khan, M.D.
• Ngum Kikah Atem, MD

• Family Nurse Practitioner in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.