Ann Louise Kettner

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502003826 Issued in MI

Practice address

3152 Peregrine Dr NE Ste 115
Grand Rapids, MI 49525-9723

Phone

(616) 643-0833

Fax

(161) 643-0844

NPI assigned

May 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1508431834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE STE 115",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-643-0833",
            "fax_number": "616-643-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE STE 115",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-643-0833",
            "fax_number": "161-643-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTNER",
        "first_name": "ANN",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne Kessler
• Denise Lynn Kesterke, RD
• Kathryn S Ketelaar, LPC
• Jessica Leigh Keto, MD
• Gabrielle Stone Kettlewell, OTR/L
• Amy Jo Kettring, LMSW
• Adele N. Keuhs, LMSW
• Lindsey Keuning, NP
• Kevin P Flood D D S-P C
• Casey Jon Key, MD

• Physical Therapy Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.