Erica Danielle Ketchum, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71006700A Issued in IN

Practice address

3903 E US Highway 30
Merrillville, IN 46410-5810

Phone

(219) 736-0900

NPI assigned

Oct 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Erica Kietzman Former name

Medicare fee-for-service enrollment

Enrolled in IN

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eketchum123538@ssdirect.comhs.org

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.

• Community Care Network Inc

  dba Powers Health Medical Group

  • Family Medicine Physician
  • Saint John, IN
  • NPI 1457610487

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1407308117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 E 61ST AVE",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426517",
            "telephone_number": "219-617-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 E US HIGHWAY 30",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105810",
            "telephone_number": "219-736-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "ERICA",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28167043A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006700A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "KIETZMAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tenisha Kennedy
• Tamara Kenning
• Cailyn Kern
• Patricia Kerr, BA
• Christy Marie Kersey, FNP-C
• Rita E Key, PHD
• Zafar U Khalid, MD
• Sohan Kumar Khatiwada, M.D
• Ali Kheirbek, MD
• Kidney Care Center Merrillville LLC

• Family Nurse Practitioner in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.