Lisa S Kettering, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33071 Issued in CO

Practice address

4 Gooseberry LN
Englewood, CO 80113-4126

Phone

(303) 781-1909

NPI assigned

Jun 19, 2006

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Yampa Valley Medical Center

  • Multi-Specialty Clinic/Center
  • Steamboat Springs, CO
  • NPI 1295177426
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1619912904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 BUCHTEL BOULEVARD",
            "address_2": "# 100758",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802500758",
            "telephone_number": "303-781-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GOOSEBERRY LN",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801134126",
            "telephone_number": "303-781-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERING",
        "first_name": "LISA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "33071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette F. Kenney, M.D.
• Petros Peter Keoseyan, DO
• Tracey Kerstein, RBT
• Glenna E Kersten, WHNP
• Jane A Kerzee
• Kevin J. Reilly, Psy.D.,P.C.
• Brandon Key, M.D.
• Jennifer Marie Key
• Kids Mile High Pediatric Dentistry and Orthodontics, PLLC
• Kids Tooth Doc

• Internal Medicine Physician in Englewood, CO
• Providers in Englewood, CO by specialty
• Internal Medicine Physician in Colorado

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