Ketasclepius LLC

Primary specialty

Integrative Medicine PhysicianTaxonomy code 202D00000X

Legal business name

KETASCLEPIUS LLC

Doing business as

The Good drop

Practice address

824 McAlpine St Ste 6
Avoca, PA 18641-1104

Phone

(570) 701-6044

NPI assigned

Dec 5, 2023

Organization subpart

No

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

Authorized official

Name

Kelly Wilson

Title

Office Manager

Phone

(727) 517-6524

Specialties & licenses 1

Addresses

Other names 1

• The Good drop Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell James, MD

  • Emergency Medicine Physician
  • Hazleton, PA
  • NPI 1780659144
  Medicare reassignment NPD

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1619744158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 MCALPINE ST STE 6",
            "city": "AVOCA",
            "state": "PA",
            "postal_code": "186411104",
            "telephone_number": "570-701-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 MCALPINE ST STE 6",
            "city": "AVOCA",
            "state": "PA",
            "postal_code": "186411104",
            "telephone_number": "570-701-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETASCLEPIUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "727-517-6524"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Good drop",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Good drop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jodi Gregory, BCBA
• Joyce Marie Hahn
• Michael Henahan, DPT
• James J Kosik, DO, PC
• Timothy Jurnak, ATC
• Keystone Independent Living Inc.
• Deborah L Khalife, PA-C
• James J Kosik, D.O.
• Joann Kosik, MHA, PA-C
• Llewellyn's LTC

• Integrative Medicine Physician in Avoca, PA
• Providers in Avoca, PA by specialty
• Integrative Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.