Individual provider Active NPI

Jessica Kate Ketz

  • Case Manager/Care Coordinator
  • Sparks, NV
National Provider Identifier
1053886739
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
480 Galletti Way
Sparks, NV 89431-5564
Phone
(775) 688-0426
Fax
(775) 688-2192
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X Primary

Addresses

Primary practice location

480 Galletti Way
Sparks, NV 89431-5564

Mailing address

480 Galletti Way
Sparks, NV 89431-5564
Phone (775) 688-0426

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1053886739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-0426",
            "fax_number": "775-688-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-0426",
            "fax_number": "775-688-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETZ",
        "first_name": "JESSICA",
        "middle_name": "KATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.