Anne H Kettler, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0422213 Issued in KS

Practice address

15101 Glenwood Ave
Stanley, KS 66223-3154

Phone

(913) 681-8866

Fax

(913) 338-1311

NPI assigned

Oct 3, 2005

Last updated

Feb 11, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

DermatologyAlso: Pathology

Education

University of Kansas School of Med (KC/Wich/Sal), 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Overland Park Surgical Specialties LLCGroup PAC ID 9234318502, 86 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.85 of 100Reported as individual

Quality

91.18

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anne.kettler@cpfc.eclinicaldirectplus.com
• Direct secure messaging: anne.kettler@hca2.eclinicaldirectplus.com

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.

• Overland Park Surgical Specialties LLC

  dba College Park Family Care Center Physicians Group

  • Family Medicine Physician
  • Overland Park, KS
  • NPI 1760798540
  Medicare reassignment Care Compare group NPD
• Hope Family Care Center,LLC

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1285878793
  Medicare reassignment NPD (past)
• College Park Family Care Center PA

  • Family Medicine Physician
  • Overland Park, KS
  • NPI 1740248772

  Dermatology

  NPD
• College Park Family Care Center, P.a.

  • Radiology Clinic/Center
  • Overland Park, KS
  • NPI 1881803229
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1659368967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503",
            "fax_number": "913-469-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15101 GLENWOOD AVE",
            "city": "STANLEY",
            "state": "KS",
            "postal_code": "662233154",
            "telephone_number": "913-681-8866",
            "fax_number": "913-338-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTLER",
        "first_name": "ANNE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "0422213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anne.kettler@cpfc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "15101 Glenwood Ave",
            "city": "Stanley",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662233154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Lynn Hartwigsen, PTA
• Kylie Hays, PA
• Madeline Howell, FNP/ENP
• Amy J Kapple, R.D. L.D. C.D.E.
• Yutaka Kawase, M.D.
• Tom Kettler, M.D.
• Brooke Nicole McGuire, NP
• Annalee Neds, FNP-C
• Overland Park Surgical Specialties, LLC (College Park Family Care Center Physicians Group)
• Robert L Schuchardt, M.D.

• Dermatology Physician in Stanley, KS
• Providers in Stanley, KS by specialty
• Dermatology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.