Active NPI
Robert M Ketchum, R.PH., M.S.
- Pharmacist
- Birmingham, AL
National Provider Identifier
1528056983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7815
- Practice address
- 2244 Vanessa Dr
Birmingham, AL 35242-4430 - Phone
- (205) 991-0462
- Fax
- (205) 991-0462
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7815 | AL | Primary |
| Pharmacist | 183500000X | 4434 | SC | |
| Pharmacist | 183500000X | 33380 | TN | |
| Pharmacist | 183500000X | 2987 | HI | |
| Pharmacist | 183500000X | 48107 | TX | |
| Pharmacist | 183500000X | 10637 | MS |
Addresses
Primary practice location
2244 Vanessa Dr
Birmingham, AL 35242-4430
Mailing address
2244 Vanessa Dr
Birmingham, AL 35242-4430
Phone (205) 991-0462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7815 | AL | MD | Pharmacist |
| 2987 | HI | MD | Pharmacist |
| 10637 | MS | MD | Pharmacist |
| 4434 | SC | MD | Pharmacist |
| 48107 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1528056983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2244 VANESSA DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352424430",
"telephone_number": "205-991-0462",
"fax_number": "205-991-0462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2244 VANESSA DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352424430",
"telephone_number": "205-991-0462",
"fax_number": "205-991-0462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHUM",
"first_name": "ROBERT",
"middle_name": "M",
"credential": "R.PH., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "7815",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "4434",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "33380",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "2987",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "48107",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "10637",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.