Kettman Pranger Family Medicine, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33683 Issued in IA

Legal business name

KETTMAN PRANGER FAMILY MEDICINE, PLLC

Practice address

220 Southbrooke Dr
Waterloo, IA 50702-5802

Phone

(319) 236-7720

Fax

(319) 236-7739

NPI assigned

May 12, 2010

Organization subpart

No

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

Authorized official

Name

Matthew J Kettman, M.D.

Title

Owner

Phone

(319) 236-7720

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.

• Lynn Renee Day, PA-C

  • Physician Assistant
  • Franklin, TN
  • NPI 1760774749
  NPD

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1902124175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507040658",
            "telephone_number": "319-236-7720",
            "fax_number": "319-236-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SOUTHBROOKE DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025802",
            "telephone_number": "319-236-7720",
            "fax_number": "319-236-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTMAN PRANGER FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "KETTMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-236-7720",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alan Kemp, MS, PT
• Jared Kennedy, DC
• Kent P Ellerbroek MD PC
• Jessica Elizabeth Kepple, CNM
• Kerry Sullivan Counseling PLLC
• Kettman Psychiatric Practice PC
• Matthew J Kettman, MD
• Ashok C Kewalramani, DO
• Maryam Ansar Khan, MD
• Shamim S Khan, MD

• Family Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.