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BRADLEY KETNER MD
NPI 1871957746
Pediatrics - Developmental - Behavioral Pediatrics in Greenville, SC

Active since April 07, 2016PECOS Enrolled
200 PATEWOOD DR BLDG A, GREENVILLE, SC 29615(864) 454-5115 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 14, 2024, Sep 30, 2019 (2 updates tracked since 2019).

About Bradley Ketner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY KETNER MD (NPI 1871957746) is an individual developmental - behavioral pediatrics provider in Greenville, South Carolina, licensed in South Carolina (LL92742) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871957746
Entity TypeIndividualMale
Primary Taxonomy2080P0006X
Provider Legal NameBRADLEY KETNERCredential: MD
Location Address200 PATEWOOD DR BLDG AGreenville, SC 29615-3593
Mailing Address200 Patewood Dr Bldg AGreenville, SC 29615-3593 · (864) 454-5115
Phone(864) 454-5115
Sole ProprietorNo
Enumeration DateApril 7, 2016
Last NPPES UpdateAugust 14, 20242 updates tracked since enumeration
NPPES CertifiedAugust 14, 2024
✔ NPI 1871957746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in SC · LL92742
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
Also ListedPediatricsTaxonomy 208000000X · License 0101262858 (VA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
200 PATEWOOD DR BLDG A, Greenville, SC 29615
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Ketner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JESSICA LAUREN MCCUE RN, BSN, FNP-S
Registered Nurse
200 PATEWOOD DR BLDG A
GREENVILLE, SC 29615
Greenville County (864) 454-2400
DR. HOLLY INGRAM MD
Pediatrics (Developmental - Behavioral Pediatrics)
200 PATEWOOD DR BLDG A
GREENVILLE, SC 29615
Greenville County (864) 455-7844

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Ketner's NPI number?

The NPI number for Bradley Ketner is 1871957746. It was assigned to this individual provider in the NPPES registry on April 7, 2016.

Where is Bradley Ketner located?

Bradley Ketner practices at 200 Patewood Dr Bldg A, Greenville, SC 29615. The listed phone number is (864) 454-5115.

What is Bradley Ketner's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Bradley Ketner enrolled in Medicare?

Yes. Bradley Ketner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bradley Ketner was last updated on August 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.