Kettlie Joseph Daniels, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

OH35057621 Issued in OH

Practice address

980 South Byrne Road
Toledo, OH 43609

Phone

(419) 842-0140

Fax

(419) 842-0142

NPI assigned

Oct 26, 2005

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

Enrolled in OH

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 1

Specialty

Psychiatry

Education

University of Toledo College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

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.

• Kettlie Joseph Daniels, MD, Inc.

  • Psychiatry Physician
  • Toledo, OH
  • NPI 1144539412
  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health - St Vincent Medical Center LLC

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1790775054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 S BYRNE RD",
            "address_2": "SUITE 250",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436091010",
            "telephone_number": "419-842-0140",
            "fax_number": "419-842-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 SOUTH BYRNE ROAD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43609",
            "telephone_number": "419-842-0140",
            "fax_number": "419-842-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "KETTLIE",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "OH35057621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Daniels
• Hannah Irene Daniels, M.A., CF-SLP
• Herbert Daniels, QMHS
• Jennifer Daniels
• Jordan A Daniels
• Latonya Sharise Daniels, CHORE PROVIDER
• Nikiki Marie Daniels, CNA
• Shanae Lakresha Daniels
• Kevin Robert Dankert, D.O.
• Anne Daoust-Garcia

• Specialist in Toledo, OH
• Providers in Toledo, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.