NPIMap

Individual provider Active NPI

Leeann McAliley Kettunen, MD

  • Family Medicine Physician
  • Enterprise, AL
National Provider Identifier
1528227220
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.32690 Issued in AL
Practice address
101 E Brunson St
Suite 200
Enterprise, AL 36330-2526
Phone
(334) 393-3686
Fax
(334) 347-4906
NPI assigned
Jun 6, 2008
Last updated
Aug 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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 MD.32690 AL Primary

Addresses

Primary practice location

101 E Brunson St
Suite 200
Enterprise, AL 36330-2526

Mailing address

101 E Brunson St
Suite 200
Enterprise, AL 36330-2526
Phone (334) 393-3686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130816000090 AL Practitioner - Family Practice 1355513201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Professional Medical Associates PCGroup PAC ID 3375574106, 11 clinicians

Practice addresses (Care Compare)

101 E Brunson St
Suite 200
Enterprise, AL 36330-2500
Phone 3343030266194

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.32690ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Associates PC CurrentSince Aug 1, 2013 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

101 E Brunson St
Ste 200
Enterprise, AL 36330
Phone (334) 303-0266

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1528227220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 200",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302526",
            "telephone_number": "334-393-3686",
            "fax_number": "334-347-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 200",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302526",
            "telephone_number": "334-393-3686",
            "fax_number": "334-347-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTUNEN",
        "first_name": "LEEANN",
        "middle_name": "MCALILEY",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.32690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.