NPIMap

Organization Active NPI

Adam Ketteler, O.D.

Doing business as Ketteler Eyecare

  • Eyewear Supplier
  • Atkinson, NE
National Provider Identifier
1710123781
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1218 Issued in NE
Legal business name
ADAM KETTELER, O.D.
Doing business as
Ketteler Eyecare
Practice address
313 W Pearl St
Atkinson, NE 68713-4958
Phone
(402) 925-2669
Fax
(402) 925-2306
NPI assigned
Dec 22, 2008
Last updated
Dec 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Authorized official

Name
Dr. Adam J Ketteler, O.D.NPI 1093734154
Title
Optometrist/Owner
Phone
(402) 925-2669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1218 NE Primary

Addresses

Primary practice location

313 W Pearl St
Atkinson, NE 68713-4958

Mailing address

PO Box 995
Atkinson, NE 68713-0995
Phone (402) 925-2669

Other names 1

  • Ketteler Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930031333 NE DME Supplier - Physician - Optometrist 8426255886 1 other NPI on this enrollment
Practice locations: Atkinson, NE

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ketteler Eyecare313 W Pearl St, Atkinson, NE 68713-4958(402) 925-2669 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 1, 2004

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229990400000",
    "number": "1710123781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 995",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687130995",
            "telephone_number": "402-925-2669",
            "fax_number": "402-925-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W PEARL ST",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687134958",
            "telephone_number": "402-925-2669",
            "fax_number": "402-925-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAM KETTELER, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2008-12-23",
        "status": "A",
        "authorized_official_last_name": "KETTELER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "402-925-2669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NE",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ketteler Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atkinson, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.