Active NPI
Suzanne Lynn Ketterhagen, HIS
- Hearing Instrument Specialist
- Chippewa Falls, WI
National Provider Identifier
1912419904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 1531-60
- Practice address
- 218 Island St
Chippewa Falls, WI 54729-2351 - Phone
- (715) 726-0931
- NPI assigned
- Oct 30, 2017
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 1531-60 | WI | Primary |
Addresses
Primary practice location
218 Island St
Chippewa Falls, WI 54729-2351
Mailing address
218 Island St
Chippewa Falls, WI 54729-2351
Phone (715) 726-0931
Other practice location 1
309 3rd Ave W Ste E
Durand, WI 54736-1165
Phone (715) 726-0931
Other practice location 2
392 Red Cedar St
Menomonie, WI 54751-2338
Phone (715) 726-0931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1531-60 | WI | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid West Hearing LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1912419904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 ISLAND ST",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547292351",
"telephone_number": "715-726-0931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 ISLAND ST",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547292351",
"telephone_number": "715-726-0931"
}
],
"practiceLocations": [
{
"address_1": "309 3rd Ave W Ste E",
"address_purpose": "LOCATION",
"city": "Durand",
"state": "WI",
"postal_code": "547361165",
"country_code": "US",
"telephone_number": "715-726-0931",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "392 Red Cedar St",
"address_purpose": "LOCATION",
"city": "Menomonie",
"state": "WI",
"postal_code": "547512338",
"country_code": "US",
"telephone_number": "715-726-0931",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KETTERHAGEN",
"first_name": "SUZANNE",
"middle_name": "LYNN",
"credential": "HIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-30",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WI",
"license": "1531-60",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chippewa Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.