Eric Lee Ketchum, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

7878T Issued in TX

Practice address

886 E Lennon Dr Ste 102
Emory, TX 75440-3216

Phone

(903) 474-9090

Fax

(903) 474-9111

NPI assigned

Jul 6, 2011

Last updated

Jul 6, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

65.83 of 100Reported as group

Quality

31.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drketchum@emoryeyecare.eyefinity-direct.com

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

• Elk Vision Holdings LLC

  dba Vision Site

  • Optometrist
  • Emory, TX
  • NPI 1619264090
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1275820649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 E LENNON DR STE 102",
            "city": "EMORY",
            "state": "TX",
            "postal_code": "754403216",
            "telephone_number": "903-474-9090",
            "fax_number": "903-474-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 E LENNON DR STE 102",
            "city": "EMORY",
            "state": "TX",
            "postal_code": "754403216",
            "telephone_number": "903-474-9090",
            "fax_number": "903-474-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "ERIC",
        "middle_name": "LEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7878T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hopkins County Physician Services (Memorial Clinic RHC)
• Hunt Memorial Hospital District (Hunt Regional Family Medicine Emory)
• Hunt Regional Medical Partners (Hunt Regional Family Medicine Emory)
• Jordan's Place Pediatrics, PA (Jordan's Place Pediatrics Emory)
• Jordan's Place Pediatrics, PA
• Lake Country Healthcare, LLC (Green Acres)
• Lake Fork Physical Therapy, PLLC
• Alexis Ledyard
• Aubree Elizabeth Lemarr, FNP-C
• Kyle Lemarr

• Optometrist in Emory, TX
• Providers in Emory, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.