MRS. KELSEY KETCHUM
NPI 1053001412
Nurse Practitioner - Family in Centerville, OH
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
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Kelsey Ketchum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Centerville, OH 45459
- Reassigned Medicare billing, Ohio enrollment
- 744 clinicians in this Medicare group
Cincinnati, OH 45230
- Reassigned Medicare billing, Ohio enrollment
- 329 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
Which organizations bill Medicare for Kelsey Ketchum's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelsey Ketchum reassigns Medicare benefits to 2 organizations: Mvhe Inc (Centerville, OH) and Cg Medical Associates Inc (Cincinnati, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelsey Ketchum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelsey Ketchum accept?
Health plans from 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Mrs. Kelsey Ketchum · NPI 1053001412
Family physician in Centerville, Ohio. Individual provider, active in the CMS NPPES registry since May 9, 2023.
## Identity
- **NPI:** 1053001412 (Entity type: Individual)
- **Enumerated:** May 9, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** APRN.CNP.0033883 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 72 GOLDENGATE DR, Centerville, OH 45459-4325
- **Phone:** (419) 605-7307
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Mvhe Inc (NPI 1912310400, Centerville, OH); Cg Medical Associates Inc (NPI 1982903951, Cincinnati, OH) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** July 24, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1053001412) · Data from the CMS NPPES public registry.