Active NPI
Christina J Ketron, DNP, APRN, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Charleston, SC
National Provider Identifier
1154977726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 23120
- Practice address
- 109 Bee St
Charleston, SC 29401-5703 - Phone
- (843) 577-5011
- NPI assigned
- Aug 9, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 23120 | SC | Primary |
Addresses
Primary practice location
109 Bee St
Charleston, SC 29401-5703
Mailing address
109 Bee St
Charleston, SC 29401-5703
Phone (843) 577-5011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200107001004 | SC | Order and Referring Only - Nurse Practitioner | 1052745676 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23120 | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1154977726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-577-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-577-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETRON",
"first_name": "CHRISTINA",
"middle_name": "J",
"credential": "DNP, APRN, PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-09",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "SC",
"license": "23120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.