Mesa Ear Nose and Throat PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD18540 Issued in AZ

Legal business name

MESA EAR NOSE AND THROAT PC

Practice address

726 N Greenfield Rd # 101
Gilbert, AZ 85234-5012

Phone

(480) 833-8620

NPI assigned

Jan 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas James Ketterer, M.D.NPI 1174501852

Title

President

Phone

(480) 833-8620

Specialties & licenses 1

Addresses

Locations

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.

• Thomas J Ketterer, M.D.

  • Otolaryngology Physician
  • Mesa, AZ
  • NPI 1174501852
  Authorized official Same address or phone

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770640930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 N GREENFIELD RD # 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345012",
            "telephone_number": "480-833-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 N GREENFIELD RD # 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345012",
            "telephone_number": "480-833-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA EAR NOSE AND THROAT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KETTERER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-833-8620",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "MD18540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Merrill, MD
• Katidiane Merrill
• Philemon R Merrill Jr., PA-C
• Jeneal Marie Merriman, OTR/L
• Kaylee Merz
• Mesa Multispecialty, LLC
• Mesa Tempe Allergy & Asthma Clinic PC
• Adam Nathaniel Mesa, PHARMD
• William Michael Meszaros, M.D.
• Phyllis Ann Metcalf

• Otolaryngology Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Otolaryngology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.