JAMIE L. KETTERMAN (RN, BSN, CDE) – Family Nurse Practitioner, NPI 1609087402
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
7,023 NURSE PRACTITIONER in MO
Provider Addresses for JAMIE L. KETTERMAN (RN, BSN, CDE)
603 E Gaines Dr
Clinton, MO 647353205
Phone: (660) 885-8141
Fax: (660) 885-5815
Type: Location
1602, North 2nd Street, Clinton, Clinton County, Iowa, 52732, United States
CLINTON, MO 647351192
Phone: (660) 885-8171
Fax: (660) 890-8422
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-10-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-10-31 (953 days ago).
Enrollment records
1
Earliest due date
2023-10-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20141006001002 | I | Nurse Practitioner | MO | 2023-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 20 | 20 | $0 |
Insurance plans in this area (ZIP 64735)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MO | 85610 | Blood test, clotting time | 30 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Family Practice | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| - | MO | |
| Family Practice | MO | |
| Internal Medicine | MO | |
| Emergency Medicine | GA | |
| - | MO | |
| - | MO | |
| Family Practice | MO | |
| Nurse Practitioner | KS |
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