Active NPI
Adam Ketchum
- Personal Care Attendant
- Bangor, ME
National Provider Identifier
1528680261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 56 Smith St Apt 2
Bangor, ME 04401-4715 - Phone
- (207) 404-0829
- NPI assigned
- May 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
56 Smith St Apt 2
Bangor, ME 04401-4715
Mailing address
56 Smith St Apt 2
Bangor, ME 04401-4715
Phone (207) 404-0829
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A&M Arkansas | Single Specialty | Current | Accepting new patients |
Organizations & group practices 1
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": "1589587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589587200000",
"number": "1528680261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 SMITH ST APT 2",
"city": "BANGOR",
"state": "ME",
"postal_code": "044014715",
"telephone_number": "207-404-0829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 SMITH ST APT 2",
"city": "BANGOR",
"state": "ME",
"postal_code": "044014715",
"telephone_number": "207-404-0829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHUM",
"first_name": "ADAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-16",
"last_updated": "2020-05-16",
"certification_date": "2020-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.