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MRS. KELSEY KETCHUM
NPI 1053001412
Nurse Practitioner - Family in Centerville, OH

Active since May 09, 2023PECOS EnrolledAccepts Medicare Assignment
72 GOLDENGATE DR, CENTERVILLE, OH 45459(419) 605-7307 Get Directions Write a Review

NPPES record last updated: July 24, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 24, 2023, Jul 5, 2023, May 9, 2023 (3 updates tracked since 2023).

About Mrs. Kelsey Ketchum NPPES

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

MRS. KELSEY KETCHUM (NPI 1053001412) is an individual family provider in Centerville, Ohio, licensed in Ohio (APRN.CNP.0033883) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1053001412
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KELSEY KETCHUM
Location Address72 GOLDENGATE DRCenterville, OH 45459-4325
Mailing Address72 Goldengate DrCenterville, OH 45459-4325 · (419) 605-7307
Phone(419) 605-7307
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateMay 9, 2023
Last NPPES UpdateJuly 24, 20233 updates tracked since enumeration
NPPES CertifiedJuly 24, 2023
✔ NPI 1053001412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · APRN.CNP.0033883
Also ListedRegistered NurseTaxonomy 163W00000X · License RN.474362 (OH)
72 GOLDENGATE DR, Centerville, OH 45459
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health Insurance.Insurance ›

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

Mrs. Kelsey Ketchum 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 ID8123472909
PECOS Enrollment IDI20230927003231
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45459 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kelsey Ketchum's NPI number?

The NPI number for Kelsey Ketchum is 1053001412. It was assigned to this individual provider in the NPPES registry on May 9, 2023.

Where is Kelsey Ketchum located?

Kelsey Ketchum practices at 72 Goldengate Dr, Centerville, OH 45459. The listed phone number is (419) 605-7307.

What is Kelsey Ketchum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kelsey Ketchum enrolled in Medicare?

Yes. Kelsey Ketchum 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.

What insurance does Kelsey Ketchum accept?

Health plans from CareSource and Oscar Health Insurance list Kelsey Ketchum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelsey Ketchum was last updated on July 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.