Active NPI
Kimberley-Rae Ketcham, MSCCC-SLP
- Speech-Language Pathologist
- Troy, OH
National Provider Identifier
1013310929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP3973
- Practice address
- 1605 Rockbridge CT
Troy, OH 45373-9559 - Phone
- (937) 726-1542
- Fax
- (937) 552-9121
- NPI assigned
- Oct 6, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP3973 | OH | Primary |
Addresses
Primary practice location
1605 Rockbridge CT
Troy, OH 45373-9559
Mailing address
1605 Rockbridge CT
Troy, OH 45373-9559
Phone (937) 726-1542
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP3973 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1013310929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1605 ROCKBRIDGE CT",
"city": "TROY",
"state": "OH",
"postal_code": "453739559",
"telephone_number": "937-726-1542",
"fax_number": "937-552-9121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 ROCKBRIDGE CT",
"city": "TROY",
"state": "OH",
"postal_code": "453739559",
"telephone_number": "937-726-1542",
"fax_number": "937-552-9121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHAM",
"first_name": "KIMBERLEY-RAE",
"credential": "MSCCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-06",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP3973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.