Individual provider Active NPI

Ladeana Ann Ketter, RN

  • Registered Nurse
  • Suffolk, VA
National Provider Identifier
1750962825
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001267615 Issued in VA
Practice address
532 W Riverview Dr
Suffolk, VA 23434-5547
Phone
(757) 593-6307
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001267615 VA Primary

Addresses

Primary practice location

532 W Riverview Dr
Suffolk, VA 23434-5547

Mailing address

532 W Riverview Dr
Suffolk, VA 23434-5547
Phone (757) 593-6307

Other names 1

  • Ladeana Cooper Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001267615VAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1750962825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 W RIVERVIEW DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345547",
            "telephone_number": "757-593-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 W RIVERVIEW DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345547",
            "telephone_number": "757-593-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTER",
        "first_name": "LADEANA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001267615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LADEANA",
            "last_name": "COOPER",
            "credential": "RN KETTER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.