Anthony Ketchersid, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP132307 Issued in TX

Practice address

6515 Kemp Blvd
Wichita Falls, TX 76308-5419

Phone

(940) 692-1220

Fax

(940) 689-5108

NPI assigned

Oct 19, 2016

Last updated

Sep 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1265983787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 ROSE ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014219",
            "telephone_number": "940-723-4488",
            "fax_number": "940-723-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763085419",
            "telephone_number": "940-692-1220",
            "fax_number": "940-689-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHERSID",
        "first_name": "ANTHONY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Grace Kempf, CRNA
• Patricia Nau Kennedy, LPC, LPA, ASOTP
• Kenneth E. Aboussie DDS
• Karen Sue Kent, LPC, LMFT
• Richard Lee Kern Jr., M.D.
• Asia Khamnuadi
• Mohammad Azeem Khan, MD
• Tania Khan, MD
• Farid Khoury, M.D.
• Dawn Kilcrease, CSFA

• Psychiatric/Mental Health Nurse Practitioner in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.