Individual provider Active NPI

Dawn M Ketchum, NP-C

  • Family Nurse Practitioner
  • Pleasant Hill, MO
National Provider Identifier
1477812923
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-75650-121 Issued in KS
Practice address
220 N State Route 7
Pleasant Hill, MO 64080-1426
Phone
(816) 867-3095
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012009899 MO
Family Nurse Practitioner 363LF0000X 53-75650-121 KS Primary

Addresses

Primary practice location

220 N State Route 7
Pleasant Hill, MO 64080-1426

Mailing address

PO Box 302
Pleasant Hill, MO 64080-0302
Phone (816) 682-5856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20121130000198 MO Practitioner - Nurse Practitioner 1456508548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1971 Tennessee Ave N
Parsons, TN 38363-5049

2000 Health Park Dr
Brentwood, TN 37027-4692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-75650-121KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Carenow Urgent Care LLC CurrentSince Jun 3, 2024 Accepting new patients
Emergent Care Plus, LLC CurrentSince Jan 29, 2015 Accepting new patients
Carespot Professional Services LLC PastSince Aug 4, 2015 Accepting new patients

Locations

1100 N 4th St
Leavenworth, KS 66048
Phone (913) 297-9945

1300 E North Ave
Belton, MO 64012
Phone (816) 406-3443

1215 NE Coronado Dr
Blue Springs, MO 64014
Phone (816) 622-3342

2741 NE McBaine Dr
Lees Summit, MO 64064
Phone (816) 554-2600

9490 E State Route 350
Raytown, MO 64133
Phone (816) 256-4089

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1477812923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640800302",
            "telephone_number": "816-682-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N STATE ROUTE 7",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640801426",
            "telephone_number": "816-867-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "DAWN",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012009899",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-75650-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, MO

Sources for this page

Verify at the official NPI Registry.