Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Tom Kettler, MD

Individual provider Family Medicine Physician · NPI 1285621615

Dr. Tom Kettler, MD is a Family Practice in Stanley, Kansas. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 1985, 41 years ago. Practices with Overland Park Surgical Specialties LLC, a 88-clinician group and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
41
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
KS
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15101 Glenwood Ave
Stanley, KS 66223-3154
Phone: (913) 681-8866
Fax: (913) 338-1311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0421569 (KS)

Record details

NPI number1285621615
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 30, 2005
Last updated in NPPESFebruary 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 1985 (41 years in practice)
Group practice Overland Park Surgical Specialties Llc — 88 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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