RAYMOND BENJAMIN KETTING (NPI# 1881631620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881631620 |
| Entity Type | Individual |
| Full Name | RAYMOND BENJAMIN KETTING |
| Credential | M.D. |
| Practice Address |
2620 N Westwood Blvd Poplar Bluff MO 63901-3396 |
| Mailing Address |
157 Terrace Trl Poplar Bluff MO 63901-8400 |
| Practice Telephone | 5737857721 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 2006000396 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | PENDING | 05 |
| Street Address |
2620 N WESTWOOD BLVD |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-3396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972589968 | Bijan Bastaninejad | Emergency Medicine | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2005-12-21 |
| 1063944932 | Michelle Heath | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2017-03-30 |
| 1558605873 | Rachel Jean Smith | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2012-11-27 |
| 1770851743 | Lisa Renee Carroll | Nurse Anesthetist, Certified Registered | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2011-12-06 |
| 1053699975 | Christopher Muiruri Kahuho | Hospitalist | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2011-07-26 |
| 1811293756 | Amy Michelle Pennington | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2011-02-09 |
| 1841592524 | Ozark Emergency Group LLC | Physician Assistant | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2010-12-01 |
| 1548562531 | Candice Leigh Copeland | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2010-11-23 |
| 1699080143 | Southeast Missouri Anesthesia Partners LLC | Nurse Anesthetist, Certified Registered | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2010-08-09 |
| 1780903021 | Charles Matthew Hollis | Nurse Anesthetist, Certified Registered | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2010-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053407858 | Edward Patrick Kreulen | Emergency Medicine | Pershing Vamc, 1500 N Westwood Blvd., Poplar Bluff, MO 63901 | 2006-10-05 |
| 1922041342 | Kenneth Charles Studyvin | Emergency Medicine | 2620 North Westwood, Poplar Bluff, MO 63901-9711 | 2006-06-14 |
| 1689632283 | Christopher R Pinderski | Emergency Medicine | 217 Physicians Park, Poplar Bluff, MO 63901-3956 | 2006-05-03 |
| 1184689200 | Richard L Wirz Jr. | Emergency Medicine | 225 Physicians Park Ste 301, Poplar Bluff, MO 63901-3930 | 2006-04-20 |
| 1972589968 | Bijan Bastaninejad | Emergency Medicine | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2005-12-21 |
| 1679822647 | Poplar Bluff Emergency Physicians, LLC | Emergency Medicine | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2012-09-05 |
| 1740560580 | State of Missouri | Emergency Medicine | 2351 Kanell Blvd, Poplar Bluff, MO 63901-4035 | 2011-08-25 |
| 1457447344 | Chun K. Hung | Emergency Medicine | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2006-10-05 |
| 1205932712 | Low Bluffs Emergency Physicians | Emergency Medicine | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2006-09-15 |
| 1407952815 | Missouri Em-1 Medical Services, P.C. | Emergency Medicine | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2006-09-15 |
| Find all providers in POPLAR BLUFF | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.