Judy Hwang Ketcham, RN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95002778 Issued in CA

Practice address

3131 Berger Ave
San Diego, CA 92123-4233

Phone

(858) 244-6800

NPI assigned

Jul 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Judy Chianyiao Hwang Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Vein InstituteGroup PAC ID 1557517489, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolina Vein Institute

  • Surgery Physician
  • Raleigh, NC
  • NPI 1609121615
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1245615020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 BERGER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234233",
            "telephone_number": "352-359-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 BERGER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234233",
            "telephone_number": "858-244-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1828 El Camino Real Ste 706",
            "address_purpose": "LOCATION",
            "city": "Burlingame",
            "state": "CA",
            "postal_code": "940103122",
            "country_code": "US",
            "telephone_number": "650-777-9117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHAM",
        "first_name": "JUDY",
        "middle_name": "HWANG",
        "credential": "RN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "HWANG",
            "middle_name": "CHIANYIAO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kirsten Kester, AUD
• Samira Kester, MFT
• Anil N Keswani, MD
• Vaishali A Keswani, O.D.
• Audrey Ketcham, RBT
• Adam Ketchesin
• Aiden Harrison Ketchum
• Katherine Clark Ketchum, M.D.
• Taylor Ketelboeter
• Louis Michael Kettel, MD

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.