Melanie Ketchmark

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

8200 Roosevelt Rd
Forest Park, IL 60130-2528

Phone

(708) 850-4889

NPI assigned

Jun 22, 2022

Last updated

Jun 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TLC Home Therapy, Inc.Group PAC ID 6002399052, 2 clinicians

Illinois Home Therapy LLCGroup PAC ID 5799178968, 18 clinicians

Livestrong Medical PLLCGroup PAC ID 3476082850, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dorforestpark@renewalrehab.net

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.

• Illinois Home Therapy LLC

  dba Legends Home Therapy

  • Physical Therapist
  • Skokie, IL
  • NPI 1114506102
  Medicare reassignment Care Compare group NPD
• Livestrong Medical PLLC

  • Nurse Practitioner
  • Mokena, IL
  • NPI 1710799788
  Medicare reassignment Care Compare group NPD
• TLC Home Therapy, Inc.

  • Occupational Therapist
  • New Lenox, IL
  • NPI 1053287334

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Livestrong Therapy LLC

  • Physical Therapist
  • Homer Glen, IL
  • NPI 1376178962
  Medicare reassignment NPD

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1285365940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 RAYMOND AVE",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "605131246",
            "telephone_number": "619-777-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 ROOSEVELT RD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302528",
            "telephone_number": "708-850-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHMARK",
        "first_name": "MELANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DORForestPark@renewalrehab.net",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8200 Roosevelt Rd",
            "city": "Forest Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601302528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie E Josler, LCPC
• Kalina Pain Institute
• Jared Allan Kalina, DO
• Atima Kamra, DDS
• Jennifer L Kemp, M.S., CCLS, CPST
• Meeae King
• David Gerard Kleinmeyer, DPT ATC L
• Gabriela Koch Da Costa Aguiar Alves
• Narmda Kumar, D.C.
• Rafiq M Kutty, MD

• Physical Therapist in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.