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

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: August 23, 2026.

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
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

Medicare Participation & PECOS CMS

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

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.

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.

Clinical Nurse Specialist
700 S SYCAMORE ST, SUITE 1
PETERSBURG, VA 23803
Clinic/Center
700 S SYCAMORE ST, SUITE 2B
PETERSBURG, VA 23803
Nurse Practitioner (Family)
700 S SYCAMORE ST
PETERSBURG, VA 23803
Clinic/Center (Medical Specialty)
700 S SYCAMORE ST, SUITE 1
PETERSBURG, VA 23803
Specialist
700 S SYCAMORE ST, STE 10
PETERSBURG, VA 23803
Nurse Practitioner (Family)
700 S SYCAMORE ST, STE #
PETERSBURG, VA 23803
Clinical Nurse Specialist
700 S SYCAMORE ST, SUITE 1
PETERSBURG, VA 23803

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.

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.