CARL ANDERSON KETCHAM DO
NPI 1023712874
Student in an Organized Health Care Education/Training Program in Las Vegas, NV
About Carl Anderson Ketcham Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARL ANDERSON KETCHAM DO (NPI 1023712874) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Winnemucca.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Carl Anderson Ketcham Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LAS VEGAS, NV 89106
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 Carl Ketcham's NPI number?
The NPI number for Carl Ketcham is 1023712874. It was assigned to this individual provider in the NPPES registry on March 27, 2023.
Where is Carl Ketcham located?
Carl Ketcham practices at 1524 Pinto Ln Fl 2, Las Vegas, NV 89106. The listed phone number is (702) 992-6888.
What is Carl Ketcham's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Carl Ketcham enrolled in Medicare?
Yes. Carl Ketcham is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Carl Ketcham was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.
# Carl Anderson Ketcham, DO · NPI 1023712874
Student in an Organized Health Care Education/Training Program provider in Las Vegas, Nevada. Individual provider, active in the CMS NPPES registry since March 27, 2023.
## Identity
- **NPI:** 1023712874 (Entity type: Individual)
- **Enumerated:** March 27, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1524 PINTO LN FL 2, Las Vegas, NV 89106-4195
- **Phone:** (702) 992-6888
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1023712874) · Data from the CMS NPPES public registry.