MICHAEL C KETCHAM DO
NPI 1912910191
Obstetrics & Gynecology in Jonesboro, AR
About Michael C Ketcham Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL C KETCHAM DO (NPI 1912910191) is an individual obstetrics & gynecology provider in Jonesboro, Arkansas, licensed in Arkansas (E-10891) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (1997).
NPPES Registry Identity
Specialties & Licenses
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
Michael C Ketcham Do 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 Reassignment
Medicare enrollment records show Michael Ketcham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jonesboro, AR 72401
- Reassigned Medicare billing, Arkansas enrollment
- 439 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 72401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
JONESBORO, AR 72401
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 Michael Ketcham's NPI number?
The NPI number for Michael Ketcham is 1912910191. It was assigned to this individual provider in the NPPES registry on August 15, 2006.
Where is Michael Ketcham located?
Michael Ketcham practices at 4802 E Johnson Ave, Jonesboro, AR 72401. The listed phone number is (870) 936-8000.
What is Michael Ketcham's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Michael Ketcham enrolled in Medicare?
Yes. Michael Ketcham 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 organization bills Medicare for Michael Ketcham's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Michael Ketcham reassigns Medicare benefits to Northeast Arkansas Clinic Charitable Foundation, Inc. (Jonesboro, AR). 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 Michael Ketcham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Michael Ketcham accept?
Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Michael Ketcham 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 Michael Ketcham was last updated on September 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Michael C Ketcham, DO · NPI 1912910191
Obstetrics & Gynecology physician in Jonesboro, Arkansas. Individual provider, active in the CMS NPPES registry since August 15, 2006.
## Identity
- **NPI:** 1912910191 (Entity type: Individual)
- **Enumerated:** August 15, 2006
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** E-10891 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 4802 E JOHNSON AVE, Jonesboro, AR 72401
- **Phone:** (870) 936-8000 · **Fax:** (870) 934-3631
## 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:** Northeast Arkansas Clinic Charitable Foundation, Inc. (NPI 1861721839, Jonesboro, AR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York College Of Osteo Medicine Of New York Institute Of Technology, class of 1997
## Record status
- **NPPES last updated:** September 7, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1912910191) · Data from the CMS NPPES public registry.