JONATHAN F. KETCHUM D.P.M. NPI 1922195627

NPI Information

NPI: 1922195627
Provider Name: JONATHAN F. KETCHUM, D.P.M.
Classification: Podiatrist - 213EP1101X
Entity Type: Individual

Specialization: Primary Podiatric Medicine

PECOS Registration: Yes

Address:
488 PLEASANT ST
WORCESTER, MA
ZIP 01609
Phone: (508) 755-9573
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Jonathan F. Ketchum, D.P.M. is a primary podiatric medicine podiatrist in Worcester, MA. Jonathan F. Ketchum, D.P.M. NPI is 1922195627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

488 PLEASANT ST
WORCESTER, MA
ZIP 01609-857
Phone: (508) 755-9573

The NPI 1922195627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 10/6/2006 and was last updated on 3/25/2008.

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
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	2087	MASSACHUSETTS	Yes

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
1	0019046	OTHER	MASSACHUSETTS	NEIGHBORHOOD HEALTH
2	333402	OTHER	MASSACHUSETTS	HARVARD PILGRIM HEALTH
3	U74325	MEDICARE UPIN	MASSACHUSETTS
4	Y75055	MEDICARE PIN	MASSACHUSETTS
5	2700355	OTHER	MASSACHUSETTS	UNITED HEALTHCARE
6	002087	OTHER	MASSACHUSETTS	TUFTS HEALTH PLAN
7	0316644	MEDICAID	MASSACHUSETTS
8	Y71045	OTHER	MASSACHUSETTS	BLUE SHIELD OF MA

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: 4/28/2024

NPI Synchronization or Removal

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