John Marshall Ketner, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

JK007570 Issued in MI

Practice address

5624 Highland Rd
Waterford, MI 48327-1926

Phone

(248) 674-9664

Fax

(248) 674-5409

NPI assigned

Jun 2, 2006

Last updated

Jun 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MI

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

General Surgery

Education

Michigan State University College of Osteopathic Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Oakland Hospital, Pontiac, MI, CCN 230207

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dana M Busch DO PLLC

  • Surgery Physician
  • Waterford, MI
  • NPI 1447435706
  NPD (past)
• Ketner Orthopedics PLLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Waterford, MI
  • NPI 1790670958
  NPD (past)

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

• McLaren Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1376564088
  Care Compare affiliation

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1801834130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5624 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271926",
            "telephone_number": "248-674-9664",
            "fax_number": "248-674-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5624 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271926",
            "telephone_number": "248-674-9664",
            "fax_number": "248-674-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETNER",
        "first_name": "JOHN",
        "middle_name": "MARSHALL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "JK007570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "5630206",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN ID",
            "identifier": "E26093",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "4621708005",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125962",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE ID",
            "identifier": "2856",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "107304",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Joy Kendricks, LPN
• Zvi Kennet, DMD, MSC
• Richard Leeland Kerre, D.D.S.
• Ketner Orthopedics PLLC
• Andrew John Ketner, D.O.
• Keystone Home Care
• Reda A Khalifa, M.D.
• Devyani S Khambete, M.D.
• Sana Khan
• Shazia Khan, OTRL

• Surgery Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.