MS. KIMBERLY A KETTER AGNP-C
NPI 1912263609
Nurse Practitioner - Gerontology in Petersburg, VA

Q: What is Kimberly Ketter's NPI number?

The NPI number for Kimberly Ketter is 1912263609. It was assigned to this individual provider in the NPPES registry on April 6, 2012.

Q: What is Kimberly Ketter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Ketter was last updated on February 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since April 06, 2012PECOS Enrolled

700 S SYCAMORE ST, PETERSBURG, VA 23803(804) 324-5051(804) 324-5049 Get Directions Write a Review

NPPES record last updated: February 12, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Ms. Kimberly A Ketter Agnp-c NPPES

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

MS. KIMBERLY A KETTER AGNP-C (NPI 1912263609) is an individual gerontology provider in Petersburg, Virginia, licensed in Virginia (0024173081) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912263609

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMS. KIMBERLY A KETTERCredential: AGNP-C

Location Address700 S SYCAMORE STPetersburg, VA 23803-5802

Mailing AddressPo Box 38004Richmond, VA 23231-0804 · (804) 873-8389 · Fax (804) 324-5049

Phone(804) 324-5051

Fax(804) 324-5049

Sole ProprietorYes

Enumeration DateApril 6, 2012

Last NPPES UpdateFebruary 12, 2016

✔ NPI 1912263609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in VA · 0024173081

Also ListedRegistered Nurse · Diabetes EducatorTaxonomy 163WD0400X · License 0001142669 (VA)

700 S SYCAMORE ST, Petersburg, VA 23803

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kimberly A Ketter Agnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Ketter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Morris Cardiovascular And Risk Reduction Center PC

9.3 mi

Cardiovascular Disease

228 JOHNSON CREEK DRIVE
Chester, VA 23836

Reassigned Medicare billing, Virginia enrollment
3 clinicians in this Medicare group

NPI 1467734863 (804) 530-1044

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 23803 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers25 claims50 services$6.49 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers12 claims13 services$1.16 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers12 claims12 services$205.35 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAUN RIVERS MSN RN

Clinical Nurse Specialist

700 S SYCAMORE ST, SUITE 1
PETERSBURG, VA 23803

Dinwiddie County (804) 324-5051

SAKUNTLA PLLC

Clinic/Center

700 S SYCAMORE ST, SUITE 2B
PETERSBURG, VA 23803

Dinwiddie County (804) 733-3333

MS. CHERYL DENISE WINSTON NURSE PRACTITIONER

Nurse Practitioner (Family)

700 S SYCAMORE ST
PETERSBURG, VA 23803

Dinwiddie County (804) 862-2878

JOHN T. MARSHALL M.D P.C

Clinic/Center (Medical Specialty)

700 S SYCAMORE ST, SUITE 1
PETERSBURG, VA 23803

Dinwiddie County (804) 862-3333

CENTRAL VIRGINIA ONCOLOGY, INC.

Specialist

700 S SYCAMORE ST, STE 10
PETERSBURG, VA 23803

Dinwiddie County (804) 732-7900

MS. MONICA SHUNITA ALLEN FNP

Nurse Practitioner (Family)

700 S SYCAMORE ST, STE #
PETERSBURG, VA 23803

Dinwiddie County (804) 862-2878

CASE MANAGEMENT ASSOCIATES LLC

Clinical Nurse Specialist

700 S SYCAMORE ST, SUITE 1
PETERSBURG, VA 23803

Dinwiddie County (804) 324-5051

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 Kimberly Ketter's NPI number?

The NPI number for Kimberly Ketter is 1912263609. It was assigned to this individual provider in the NPPES registry on April 6, 2012.

Where is Kimberly Ketter located?

Kimberly Ketter practices at 700 S Sycamore St, Petersburg, VA 23803. The listed phone number is (804) 324-5051.

What is Kimberly Ketter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Kimberly Ketter enrolled in Medicare?

Yes. Kimberly Ketter is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Ketter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Ketter reassigns Medicare benefits to Morris Cardiovascular And Risk Reduction Center PC (Chester, VA). The 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 Kimberly Ketter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Ketter was last updated on February 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.