Jacob Kettner, PT
NPI 1225683808ActiveIndividual· Physical Therapist· Warrensburg, MO
Physical Therapist (PT) with Advanced Physical Therapy LLC, practicing in Warrensburg, Missouri. Medicare paid $16,614 for services to 48 patients in 2024.
Overview
| NPI | 1225683808 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | No |
| NPI issued | Aug 9, 2019 |
| Last updated in NPPES | Dec 23, 2024 |
| Certified by provider | Dec 23, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | CP034808T | MO |
| Physical Therapist, Pediatrics | 2251P0200X | — | — |
| Physical Therapist | 225100000X | PT4666 | AR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (AR); Practitioner - Physical Therapist in Private Practice (MO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 48 |
|---|---|
| Services billed | 847 across 11 procedure codes |
| Paid by Medicare | $16,614 |
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Advanced Physical Therapy LLCStilwell, OK · 11 clinicians
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