DR. COREY J KETCHEM MD
NPI 1043743446
Student in an Organized Health Care Education/Training Program in Chapel Hill, NC

Q: What is Corey Ketchem's NPI number?

The NPI number for Corey Ketchem is 1043743446. It was assigned to this individual provider in the NPPES registry on April 4, 2017.

Q: What is Corey Ketchem's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Corey Ketchem was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since April 04, 2017PECOS EnrolledAccepts Medicare Assignment

102 MASON FARM RD, CHAPEL HILL, NC 27599(984) 984-4462(919) 843-9355 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 3, 2025, Apr 17, 2019 (2 updates tracked since 2019).

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About Dr. Corey J Ketchem Md NPPES

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

DR. COREY J KETCHEM MD (NPI 1043743446) is an individual student in an organized health care education/training program in Chapel Hill, North Carolina and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1043743446

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. COREY J KETCHEMCredential: MD

Location Address102 MASON FARM RDChapel Hill, NC 27599-6134

Mailing Address102 Mason Farm RdChapel Hill, NC 27599-6134 · (984) 984-4462 · Fax (919) 843-9355

Phone(984) 984-4462

Fax(919) 843-9355

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2019

Enumeration DateApril 4, 2017

Last NPPES UpdateJune 3, 20252 updates tracked since enumeration

NPPES CertifiedJune 3, 2025

✔ NPI 1043743446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X · License 036174084 (IL)

102 MASON FARM RD, Chapel Hill, NC 27599

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Secondary Practice Location 1

Location 1259 E Erie St Ste 1600Chicago, IL 60611-3111 · Phone (312) 695-5620 · Fax (312) 695-2778

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Corey J Ketchem Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496088312

PECOS Enrollment IDI20250609002504

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140281

Location251 E Huron StChicago, IL 60611 · Cook County

Emergency services Birthing friendly

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.

UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL

Pharmacy

102 MASON FARM RD, 3RD FLOOR, ROOM 3301
CHAPEL HILL, NC 27599

Orange County (919) 966-7689

SUSAN JACQUELYN CAVANAUGH AGNP-C

Nurse Practitioner

102 MASON FARM RD
CHAPEL HILL, NC 27599

Orange County (919) 974-4175

DR. JONATHAN DAVID SORAH M.D.

Student in an Organized Health Care Education/Training Program

102 MASON FARM RD, AMBULATORY CARE CENTER
CHAPEL HILL, NC 27599

Orange County (919) 966-1459

BRIAN KELLEY

Student in an Organized Health Care Education/Training Program

102 MASON FARM RD
CHAPEL HILL, NC 27599

Orange County (919) 966-1459

ZACHARY SCOTT TUGAOEN MD

Internal Medicine

102 MASON FARM RD
CHAPEL HILL, NC 27599

Orange County (984) 974-4462

DR. MONICA REYNOLDS MD

Internal Medicine (Nephrology)

102 MASON FARM RD
CHAPEL HILL, NC 27599

Orange County (984) 974-5706

DR. EMILY CROWDER SANDERS MD

Student in an Organized Health Care Education/Training Program

102 MASON FARM RD
CHAPEL HILL, NC 27599

Orange County (919) 966-1459

DEREK LANGSTON

Physical Therapist

102 MASON FARM RD
CHAPEL HILL, NC 27599

Orange County (919) 966-7400

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 Corey Ketchem's NPI number?

The NPI number for Corey Ketchem is 1043743446. It was assigned to this individual provider in the NPPES registry on April 4, 2017.

Where is Corey Ketchem located?

Corey Ketchem practices at 102 Mason Farm Rd, Chapel Hill, NC 27599. The listed phone number is (984) 984-4462.

What is Corey Ketchem's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Corey Ketchem enrolled in Medicare?

Yes. Corey Ketchem is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Corey Ketchem affiliated with any hospitals?

According to CMS data, Corey Ketchem is affiliated with Northwestern Medicine Central Dupage Hospital and Northwestern Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Corey Ketchem was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.