ALICIA HAGENAU KETCHUM ARNP-C NPI 1588080501

NPI Information

  • NPI: 1588080501
  • Provider Name: ALICIA HAGENAU KETCHUM, ARNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 120 MEDICAL BLVD
    STE 102
    SPRING HILL, FL
    ZIP 34609
  • Phone: (352) 686-0086

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NPI Details

Alicia Hagenau Ketchum, ARNP-C is a family nurse practitioner in Spring Hill, FL. Alicia Hagenau Ketchum, ARNP-C NPI is 1588080501. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

120 MEDICAL BLVD
STE 102
SPRING HILL, FL
ZIP 34609-220
Phone: (352) 686-0086
Fax: (352) 684-2081

The NPI 1588080501 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)
  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
  • Established patient custodial care facility, group care, or assisted living visit, typically 1 hour (HCPCS:99337)
  • Established patient home visit, typically 1 hour (HCPCS:99350)
  • Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes (HCPCS:99336)

The enumeration date for this NPI number is 3/14/2014 and was last updated on 2/20/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyARNP9278289FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1016886300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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