Reid S Ketteler, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4670 Issued in KS

Practice address

5363 Roberts St
Shawnee, KS 66226-3938

Phone

(913) 422-8929

Fax

(913) 422-0061

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sports Medicine Consultants

  • Family Medicine Physician
  • Shawnee, KS
  • NPI 1841512167
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1811090483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 ROBERTS ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263938",
            "telephone_number": "913-422-8929",
            "fax_number": "913-422-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 ROBERTS ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662263938",
            "telephone_number": "913-422-8929",
            "fax_number": "913-422-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTELER",
        "first_name": "REID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "4670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "629155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27843012",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "452211",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7811171",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie L Kelly, RN
• Heather Kenworthy, LPN
• Katherine Elisabeth Kerner, APRN, FNP-C
• Nicole Kerr
• Brittany Kershaw
• Wilson Keungkhamphong, COTA
• Jawaria Khalid, MD
• Khia Chiropractic LLC (Khia Chiropractic)
• Kiene Dental Group (Kiene Generations) (Kiene Dental Group)
• Kiene Dental Group LLC

• Chiropractor in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.